Omega-3 fatty acids, acute coronary syndrome, and sudden death

Omega-3 fatty acids (FAs) are currently recommended to reduce the risk of cardiovascular diseases. These recommendations are based on randomized trials, prospective cohort studies, and case-control data and are supported by experimental studies in humans, animals, and isolated cells. Raising tissue levels of omega-3 FAs reduces the risk of sudden cardiac death, most likely due to reduced susceptibility to fatal arrhythmias, but the effect of these FAs on the risk of myocardial infarction per se is less clear. Reductions in nonfatal events have not typically been seen in randomized trials, but case-control and prospective cohort studies support such an effect. Future studies should assess tissue levels of omega-3 FAs to more precisely estimate exposure and to more clearly define the relations between omega-3 status and the risk of fatal or nonfatal cardiovascular diseases.