Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Omega-3s & Statins Prevent Coronary Plaque Progression

When added to statins, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) prevents coronary plaque progression in patients without diabetes with mean low-density lipoprotein cholesterol (LDL-C) <80 mg/dL, when an index ≥4% was achieved. This according to a recent study aimed to determine a target level of EPA and DHA to prevent progression of coronary artery plaque. 218 participants (mean age 62.9 years, mean LDL-C level 78.6 mg/dL, and median triglyceride level 122 mg/dL) with stable coronary artery disease on statins were randomized to high-dose EPA and DHA or no omega-3 for 30 months. Researchers found:

  • Participants assigned to EPA and DHA had increased plasma EPA and DHA levels variably from 1.85% to 13.02%.
  • Plasma omega-3 fatty acid index ≥4% prevented progression of fibrous, noncalcified, calcified, and total plaque in patients with diabetes whereas those in the lowest quartile had significant progression of fibrous, calcified, and total plaque.
  • No difference was observed in patients with diabetes.


Alfaddagh A, Elajami TK, Saleh M, et al. An omega-3 fatty acid plasma index ≥4% prevents progression of coronary artery plaque in patients with coronary artery disease on statin treatment. [Published online ahead of print April 13, 2019]. Atherosclerosis. doi:10.1016/j.atherosclerosis.2019.04.213.