Omega-3 ethylester concentrate: a review of its use in secondary prevention post-myocardial infarction and the treatment of hypertriglyceridaemia.

Oral omega-3 ethylester concentrate (omega-3 EEC) [Omacor; Lovaza] is indicated as an adjuvant therapy in adult patients for secondary prevention post-myocardial infarction (MI) and the treatment of hypertriglyceridaemia in the majority of European countries, and for the treatment of hypertriglyceridaemia (serum triglyceride levels > or =5.6 mmol/L [> or =500 mg/dL]) in the US. Each 1000 mg capsule of omega-3 EEC consists of 460 mg of ethyl eicosapentaenoic acid and 380 mg of ethyl docosahexaenoic acid. The addition of omega-3 EEC 1000 mg/day to standard medical therapy in the GISSI-Prevenzione study provided secondary prevention benefits in post-MI adult patients. The benefits were attributable to reductions in death and cardiovascular death (including sudden death). Additional data examining the extent and mechanisms of the cardiovascular benefit conferred by omega-3 EEC in secondary prevention would be useful. As an adjunct to diet, monotherapy with omega-3 EEC 4000 mg/day significantly reduced triglyceride levels in patients with hypertriglyceridaemia, although limited data suggest it was less effective than gemfibrozil. In addition, omega-3 EEC 4000 mg/day plus simvastatin or atorvastatin reduced triglyceride, non-high-density lipoprotein cholesterol (non-HDL-C) and/or very-low-density lipoprotein cholesterol (VLDL-C) levels to a significantly greater extent than placebo plus simvastatin or atorvastatin. Omega-3 EEC was generally well tolerated both as secondary prevention post-MI and in the treatment of hypertriglyceridaemia. Thus, omega-3 EEC is a useful option both in secondary prevention post-MI and the treatment of hypertriglyceridaemia.