Abstract 13318: Omega-3 Ethyl Esters and Atrial Fibrillation or Flutter in Patients With Coronary Artery Disease: Results From a Randomized Trial

Abstract

Introduction: Statins have led to significant reductions in cardiovascular disease (CVD) events; however, a high level of residual cardiovascular risk remains. The REDUCE-IT trial showed additional benefit with icosapent ethyl to statins in reducing CVD morbidity and mortality. However, the safety of omega-3 ethyl esters with regards to atrial fibrillation (Afib) in patients with coronary artery disease (CAD) remains unclear. Hypothesis: We hypothesize that omega-3 ethyl esters may influence the risk of Afib or flutter in patients with CAD. Methods: In total, 285 CAD patients on statins were randomized to high dose omega-3 ethyl esters (1.86 g of Eicosapentaenoic acid [EPA] and 1.5 g of Docosahexaenoic acid [DHA]) or no omega-3 for 30 months. The incidence and recurrence of Afib or flutter was compared in those on EPA/DHA plus statin to statin alone (control). Results: A total of 240 patients were included in the analysis and no difference in baseline characteristics was observed (Table A). In total, 19 patients were in Afib or flutter during the trial: 12 in EPA/DHA and 7 in control (9.5% vs. 6.1%, respectively, p=0.33). The incidence of new onset Afib or flutter within 30 months was 7.2% and 4.9% in patients receiving omega-3 ethyl esters compared to controls, respectively (p=0.48). No significant difference in recurrence of Afib occurred among patients with a history of paroxysmal Afib receiving omega-3 ethyl esters compared to control (26.7% vs. 16.7%, respectively, p=0.53) (Table B). Conclusions: EPA/DHA did not increase the incidence of Afib or flutter in patients with established CAD. Further studies are warranted to better understand the effects of omega-3 ethyl esters on the cardiac conduction system.