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Do You Think Fish Oil Has Cardiovascular Benefits

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Questions about the cardiovascular benefit of omega-3 fatty acids and the high-dose eicosapentaenoic acid (EPA) product icosapent ethyl (Vascepa) have resurfaced with the STRENGTH trial, which was presented at the recent American Heart Association (AHA) virtual conference. The STRENGTH trial showed no benefit on cardiovascular event rates of a high-dose combination of EPA and docosahexaenoic acid (DHA) in a new branded product (Epanova).This contrasts with the very positive results of last year’s REDUCE-IT trial, which showed a 25% relative risk reduction in major adverse cardiovascular events with the high-dose purified EPA product, icosapent ethyl.  Proposed explanations for the discrepancies include the fact that different placebos were used in the two trials, with some suggesting that mineral oil is an active placebo. The REDUCE-IT investigators dispute this; their explanation is that DHA may counteract some of the benefits of EPA.

Question 1 of 6

Why do you think icosapent ethyl reduced CV events in REDUCE-IT, in contrast to other fish oil formulations?

Higher serum EPA

Absence of DHA

Study population


Question 2 of 6

Do you think DHA counteracts the benefits of EPA?



Unsure, more investigation needed

Question 3 of 6

Should there be another trial of icosapent ethyl using a corn oil placebo?




Question 4 of 6

Should combined EPA/DHA fish oil products be withdrawn as a treatment? (Select all that apply)

Yes, for supplements

Yes, for prescription products

No, they should not be withdrawn

Question 5 of 6

Are you concerned about the increased risk for atrial fibrillation seen in some of the fish oil trials?

Yes, for all formulations

Yes, for some formulations

No, I have no concerns

Question 6 of 6

Will any of the fish oil trial results presented at AHA change your prescribing patterns? Please share your thoughts here.


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