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Pastimes : Heart Attacks, Cancer and strokes. Preventative approaches

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From: LindyBill	8/21/2008 9:22:58 PM
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I am starting to get some answers to John's question about Fish Oil/Aspirin problems: Here are two studies: Bender NK Kraynak MA, et al. Effects of marine fish oil on the anticoagulation status of patients receiving chronic warfarin therapy. Journal of Thrombosis and Thrombolysis. 1998;5(3):257-261 (This study examined the existence and magnitude of the effect of various doses of fish oil supplements on INR in patients receiving chronic warfarin therapy) Sixteen subjects underwent a 4-week placebo monitoring period in which INRs were determined on a weekly basis. If the INRs were found to be stable, patients were randomized to receive a 4-week treatment period of either placebo capsules (n - 6), 3 grams of fish oil daily (n = 5) or 6 grams of fish oil daily (n - 5). Patients were followed on a twice-weekly basis for INR determinations and adverse reactions. Five patients were discontinued from the study due to noncompliance (2) and unstable INRs (3). There was no statistically significant difference in INRs between the placebo lead-in and treatment period within each group (P = 0.82). There was also no difference in INRs found between groups (P = 0.41). One bruising episode was reported, yet no major bleeding episodes were observed during the study. Fish oil supplementation in doses of 3-6 grams per day does not seem to create a statistically significant effect on the anticoagulation status of patients receiving chronic warfarin therapy. ------------------------------------- Eritsland J, Arnesen H, et al. Long-term effects of n-3 polyunsaturated fatty acids on haemostatic variables and bleeding episodes in patients with coronary artery disease. Blood Configuration & Fibrinolysis. 1995;6(1):17-22 (This study examined the long-term effects of fish-oil supplements on haemostatic parameters and bleeding episodes in patients undergoing coronary artery bypass grafting.) They were investigated before and 9 months after the operation. Following randomization postoperatively, 260 patients received 4 g fish-oil concentrate per day, whereas 251 patients comprised the control group. All patients received either aspirin (300 mg/day) or warfarin (international normalized ratio aimed at 2.5-4.2). Compliance was affirmed by determination of serum phospholipid fatty acids. No excess of bleeding episodes could be attributed to the use of fish oil, given in addition to either aspirin or warfarin. The supplementation of fish oil did not affect the bleeding time or plasma levels of beta-thromboglobulin, whereas an increase in the platelet count after the operation was slightly less pronounced in the fish-oil group. Apart from a small increase in PAI-1 antigen of borderline significance, no long-term effects by fish oil on parameters of coagulation and fibrinolysis were seen.

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