Summary
Twenty patients accepted for coronary bypass surgery were randomized to receive either
a concentrated ethylester compound of n-3 fatty acids, with a daily dose of 3.15 g
of eicosapentaenoic acid (EPA) and 1.89 g of docosahexaenoic acid (DHA), or corn oil
(controls) in a double blind study, to evaluate the effect on lipids, platelets and
coagulation during the pre- and postoperative phase.
Only patients with fasting triglyceride (TG) levels ≥1.6 mmol/1 at recruitment were
eligible. The study was continued for 5 to 6 months. Surgery was usually performed
at mid-intervention. Blood samples were collected during morning hours in fasting
subjects, just prior to intervention, preoperatively and at final postoperative follow-up.
Moreover, blood loss was accurately accounted for postoperatively.
A threefold increase (p = 0.0001) of EPA was noted at pre-and postoperative follow-up.
TG-levels were reduced 20 and 39%, respectively, in patients on n-3 fatty acids, reaching
statistical significance at end of intervention (p = 0.034). TG-levels in controls
remained largely unchanged. In patients on n-3 fatty acids, there was a statistically
significant increase in serum total cholesterol preoperatively, but this change was
no longer present at completion of the study.
No significant changes were noted in platelet function, as judged by bleeding time,
collagen induced platelet aggregation and release of TxB2 during aggregation. Parameters of extrinsic coagulation, including phospholipase
C-sensitive factor VII (PLC-VII) and extrinsic pathway inhibitor (EPI), also remained
essentially unchanged in both groups of patients. However, fibrinogen was significantly
reduced in controls (p <0.05) at end of intervention. Moreover, a strong positive
correlation was noted between PLC-VII and TG (r = 0.77, p = 0.0001).
No significant difference in postoperative bleeding was noted between the two groups
of patients.
