No effect of n-3 fatty acids supplementation on NT-proBNP after myocardial infarction: The Alpha Omega Trial

Ellen K. Hoogeveen, Johanna M. Geleijnse, Daan Kromhout, Peter van 't Sant, Eugenie F. Gemen, Ron Kusters, Erik J. Giltay

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Background: Heart failure is a major risk factor for cardiovascular mortality, for which n-3 fatty acids may have beneficial effects. We examined the effect of marine eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and plant-derived alpha-linolenic acid (ALA) on N-Terminal-pro Brain Natriuretic Peptide (NT-proBNP), a biomarker of heart failure.

Methods: We randomly assigned 4837 post-myocardial infarction patients, aged 60–80 years (82% men), to margarines supplemented with a targeted additional intake of 400 mg/day EPA and DHA, 2 g/day ALA, EPA-DHA plus ALA, or placebo for 40 months. In a random selection of 639 patients, NT-proBNP was determined both at baseline and at the end of follow-up. NT-proBNP was loge-transformed and analysed by type of treatment using analysis of covariance adjusting for baseline NT-proNBP.

Results: Patients consumed on average 19.8 g margarine/day, providing an additional amount of 238 mg/day EPA with 158 mg/day DHA, 1.98 g/day ALA, or both, in the active-treatment groups. In the placebo group, the geometric mean level NT-proBNP increased from 245 ng/l (95%-confidence interval [CI]: 207–290) to 294 ng/l (95%-CI: 244–352) after 40 months (p = 0.001). NT-proBNP levels were not affected by ALA (+8% versus placebo; 95%-CI: −8% to +25%; p = 0.34), EPA-DHA (+2% versus placebo; 95%-CI: −14% to +18%; p = 0.78), nor EPA-DHA plus ALA (+9% versus placebo; 95%-CI: −8% to +25%; p = 0.31) treatment.

Conclusions: Supplementation with modest amounts of EPA-DHA, with or without ALA, did not have a significant effect on NT-proBNP levels in patients with a history of myocardial infarction.
Original languageEnglish
Pages (from-to)648-655
JournalEuropean journal of preventive cardiology
Issue number5
Publication statusPublished - May 2015


  • n-3 Polyunsaturated fatty acids
  • Alpha-linolenic acid
  • Eicosapentaenoic acid
  • Docosahexaenoic acid
  • NT-proBNP
  • Randomized double-blind placebo-controlled trial


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