Long-Chain N-3 Polyunsaturated Fatty Acids and Out-of-Hospital Primary Cardiac Arrest: Clinical and Public Health Implications of Observational Studies and Clinical Trials

GISSI-Prevenzione findings provide additional support for the association of dietary intake of long-chain n-3 polyunsaturated fatty acids (PUFAs) from seafood [eicosapentaenoic acid (EPA; 20:5n-3) and docosahexaenoic acid (DHA; 22:6n-3) with the risk of coronary heart disease (CHD) mortality and sudden cardiac death. The findings also complement evidence from animal-experimental studies, cell biology and dietary intervention trials that suggest that long-chain n-3 PUFAs may protect against the life-threatening ventricular arrhythmias that result in sudden cardiac death. In this report, we review (1) several issues initially raised in the interpretation of clinical epidemiological studies of the association of long-chain n-3 PUFAs and the risk of CHD and (2) findings from a population-based case-control study of dietary intake and cell-membrane levels of long chain n-3 PUFAs from seafood and the risk of primary cardiac arrest, that complements the findings from the GISSI-Prevenzione trial. Taken together, the available data supports both the role of low-dose, long-chain n-3 PUFAs in the prevention of sudden cardiac death and further targeted clinical research to examine more fully the effects of low-dose, long-chain n-3 PUFAs on the occurrence of life-threatening ventricular arrhythmias in other clinically defined, high-risk populations. (C) 2001 The European Society of Cardiology.