2. What were the results?
Primary endpoint Fish oil Control p-value ARR NNT
all-cause death + non-fatal MI + non-fatal stroke 12.3% 14.6% .02 2.3% 43
CV death + non-fatal MI + non-fatal stroke 9.2% 11.4% .008 2.2% 45
All fatal events 8.3% 10.4% .02 2.1% 48
CV-deaths 4.8% 6.8% .02 2.0% 50
CHD death and non-fatal MI 6.9% 9.2% .02 2.3% 43
Fatal and nonfatal MI 1.9% 1.5% NS
Comparing data of vitamin E and placebo - no significant differences in composite outcomes, death and events.
There was no increased benefit of combining fish oil and vitamin E
3. Will the results help me?
* similar baseline diets (Mediterranean diet habits)
* 28% of fish oil patients stopped taking the drug by end of study
* 3.8% of fish oil patients D/C drug as a result of side effects
* no real change in lipid numbers from baseline
* limitation - open-label design
Conclusion: Long-term fish oil at 1 gram per day is effective at reducing death, mainly cardiovascular death. Essentially 22 out of 1000 patients at
low risk with LDL’s around 138 and normal triglycerides would benefit from taking fish oil. None would benefit from vitamin E or the addition of
vitamin E to fish oil. A month of fish oil would cost $.
Fish Oil Facts
* GISSI-Prevenzione Study in patients with CHD, the dose is 1 gm per day.
* To lower triglycerides, the dose is increased to 2 to 4 gm per day
Main Side Effect
* high doses might increase bleeding potential, especially those on aspirin and anticoagulants