[Fish oil in thrombosis and arteriosclerosis]

In the past few years interest in the use of fish oil as a dietetic approach in the management of thromboarteriosclerotic diseases has increased. This is based on epidemiological studies which indicate that people living mainly on a fish diet have a low incidence of coronary heart disease (CHD). The beneficial effect is attributed to the high content of polyunsaturated n-3 fatty acids (PUFA), especially eicosapentaenoic acid (C20:5n-3) (EPA), in the marine diet. These fatty acids are built into the phospholipids of various cell membranes, changing their biological reactivity. EPA and docosahexaenoic acid (C22:6n-3) are also metabolized into specific eicosanoids (e.g. prostaglandin I3, thromboxane A3 and leukotriene B5). In contrast to the mediators originating from the n-6 fatty acids, these n-3 autocoids exhibit stronger antiaggregant, vasodilatory and anti-inflammatory activities. When given to volunteers, n-3 PUFAs inhibit platelet aggregation and lower plasma triglycerides. However, first clinical studies in patients with angina pectoris are equivocal. Furthermore, restenosis of coronary arteries in patients after PTCA was not clearly reduced. Therefore, more prospective clinical studies are needed to establish the efficacy of these fish oils before their use in thromboarteriosclerotic CHD can be recommended.