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Effect of High Dose Fish Oil Supplementation After Recent Heart Attack Using Magnetic Resonance Imaging (OmegaREMODEL)

Primary Purpose

Myocardial Infarction, Death, Sudden, Cardiac

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Omega-3 Fatty Acids (Fish Oil Supplements)
Placebo
Sponsored by
Brigham and Women's Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myocardial Infarction focused on measuring Heart Attack, Sudden Cardiac Death, Peri-infarct Zone, Omega-3 Fatty Acids, Biological Markers, Cytogenetic Analysis, Cardiac Arrest

Eligibility Criteria

21 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Experienced a heart attack in the 2 to 4 weeks before study entry
  • Lives in the greater Boston area or adjacent regions (within a 50-mile radius of Boston)

Exclusion Criteria:

  • Unable to undergo an MRI because of metallic implants (e.g., pacemakers, an implantable cardioverter defibrillator [AICD]) at time of study entry
  • Active cancer or any other terminal illness with an expected survival rate of less than 6 months after study entry
  • Significant kidney dysfunction with a glomerular filtration rate (GFR) of less than 60 mL/min in the 2 weeks before study entry
  • Inability to follow study procedures
  • Pregnant
  • Hemodynamic instability
  • Urgent clinical need for a pacemaker or AICD
  • Inaccessibility of medical records

Sites / Locations

  • Brigham and Women's Hospital, Shapiro Cardiovascular Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Omega-3 Fatty Acids

Placebo

Arm Description

Participants will receive a highly purified form of omega-3 fatty acids for 6 months.

Participants will receive placebo for 6 months.

Outcomes

Primary Outcome Measures

Effect of Omega-3 Fatty Acids on Adverse Left Ventricular Remodeling
Measured as change in left ventricular end-systolic volume indexed to body surface area from baseline to post-treatment (6-months)

Secondary Outcome Measures

Effect of Omega-3 Fatty Acids on Non-Infarct Myocardial Fibrosis
Measured as change in myocardial extracellular volume fraction of non-infarcted myocardium from baseline to post-treatment (6-months)
Effect of Omega-3 Fatty Acids on Left Ventricular Ejection Fraction
Measured as change in left ventricular ejection fraction from baseline to post-treatment (6-months)
Effect of Omega-3 Fatty Acids on Infarct Size
Measured as change in infarct size from baseline to post-treatment (6-months)

Full Information

First Posted
August 4, 2008
Last Updated
May 25, 2017
Sponsor
Brigham and Women's Hospital
Collaborators
National Heart, Lung, and Blood Institute (NHLBI), GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT00729430
Brief Title
Effect of High Dose Fish Oil Supplementation After Recent Heart Attack Using Magnetic Resonance Imaging
Acronym
OmegaREMODEL
Official Title
Prognostic, Anti-arrhythmic, and Ventricular Remodeling Effects of High Dose Fish Oil in Patients With a Recent Myocardial Infarction
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
August 2008 (undefined)
Primary Completion Date
October 2013 (Actual)
Study Completion Date
July 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Brigham and Women's Hospital
Collaborators
National Heart, Lung, and Blood Institute (NHLBI), GlaxoSmithKline

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Doctors use magnetic resonance imaging (MRI) to obtain detailed pictures of the inside of the body. This study will evaluate a new MRI technique in people who have recently had a heart attack. Researchers will also examine the effect of fish oil supplementation on heart health in study participants.
Detailed Description
A new MRI technique to examine the heart was recently developed. In this study, researchers will use this new technique to evaluate the heart in people who have recently had a heart attack to determine whether a specific pattern of heart muscle damage is related to sudden cardiac death. This fatal condition, also known as cardiac arrest, occurs when the heart abruptly stops pumping blood to the body, resulting in loss of consciousness, absence of pulse, and a stop in breathing. The most common cause of sudden cardiac death is a heart attack. In addition to evaluating the new heart MRI technique, this study will also examine the effects of fish oil supplementation in people who have recently had a heart attack. Recent research has shown that omega-3 fatty acids, commonly found in fish oil, may be beneficial for people with heart conditions. Lastly, the study will determine whether specific biomarkers and genetic factors can help predict the likelihood of a person dying from sudden cardiac death after previously experiencing a heart attack. Apart from studying the likelihood of sudden cardiac death, This study will measure the change in structure and pumping function of the heart (known as ventricular remodeling) and this study will determine if the high dose of fish oil treatment will result in an improvement of the heart. This study will enroll people who have had a heart attack in the 2 to 4 weeks before study entry. At a baseline study visit, participants will undergo an MRI of their heart and complete an exercise stress test on a treadmill. A blood sample will be collected, and women will provide a urine sample for a pregnancy test. Questionnaires asking about diet, medical history, and emotions will also be completed. Participants will then be randomly assigned to receive either fish oil supplements or placebo on a daily basis for 6 months. Every 2 to 3 months, study researchers will call participants to check on their health and progress. At a study visit at Month 6, participants will undergo repeat baseline testing. After this visit, study researchers will call participants every 6 months for 3 years to follow up on participants' health status.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myocardial Infarction, Death, Sudden, Cardiac
Keywords
Heart Attack, Sudden Cardiac Death, Peri-infarct Zone, Omega-3 Fatty Acids, Biological Markers, Cytogenetic Analysis, Cardiac Arrest

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
358 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Omega-3 Fatty Acids
Arm Type
Experimental
Arm Description
Participants will receive a highly purified form of omega-3 fatty acids for 6 months.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will receive placebo for 6 months.
Intervention Type
Drug
Intervention Name(s)
Omega-3 Fatty Acids (Fish Oil Supplements)
Other Intervention Name(s)
Lovaza (GlaxoSmithKline)
Intervention Description
4 grams of omega-3 fatty acids taken orally once per day for 6 months
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Corn oil placebo
Intervention Description
Placebo tablets taken orally once per day for 6 months
Primary Outcome Measure Information:
Title
Effect of Omega-3 Fatty Acids on Adverse Left Ventricular Remodeling
Description
Measured as change in left ventricular end-systolic volume indexed to body surface area from baseline to post-treatment (6-months)
Time Frame
Before and after study treatments
Secondary Outcome Measure Information:
Title
Effect of Omega-3 Fatty Acids on Non-Infarct Myocardial Fibrosis
Description
Measured as change in myocardial extracellular volume fraction of non-infarcted myocardium from baseline to post-treatment (6-months)
Time Frame
Measured in the 3-year follow-up period after participant's last study visit
Title
Effect of Omega-3 Fatty Acids on Left Ventricular Ejection Fraction
Description
Measured as change in left ventricular ejection fraction from baseline to post-treatment (6-months)
Time Frame
Measured in the 3-year follow-up period after participant's last study visit
Title
Effect of Omega-3 Fatty Acids on Infarct Size
Description
Measured as change in infarct size from baseline to post-treatment (6-months)
Time Frame
Measured in the 3-year follow-up period after participant's last study visit

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Experienced a heart attack in the 2 to 4 weeks before study entry Lives in the greater Boston area or adjacent regions (within a 50-mile radius of Boston) Exclusion Criteria: Unable to undergo an MRI because of metallic implants (e.g., pacemakers, an implantable cardioverter defibrillator [AICD]) at time of study entry Active cancer or any other terminal illness with an expected survival rate of less than 6 months after study entry Significant kidney dysfunction with a glomerular filtration rate (GFR) of less than 60 mL/min in the 2 weeks before study entry Inability to follow study procedures Pregnant Hemodynamic instability Urgent clinical need for a pacemaker or AICD Inaccessibility of medical records
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Raymond Y. Kwong, MD, MPH
Organizational Affiliation
Brigham and Women's Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Brigham and Women's Hospital, Shapiro Cardiovascular Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Plan to share data with GISSI Heart Failure group for pooling and meta-analysis
Citations:
PubMed Identifier
16801462
Citation
Yan AT, Shayne AJ, Brown KA, Gupta SN, Chan CW, Luu TM, Di Carli MF, Reynolds HG, Stevenson WG, Kwong RY. Characterization of the peri-infarct zone by contrast-enhanced cardiac magnetic resonance imaging is a powerful predictor of post-myocardial infarction mortality. Circulation. 2006 Jul 4;114(1):32-9. doi: 10.1161/CIRCULATIONAHA.106.613414. Epub 2006 Jun 26.
Results Reference
background
PubMed Identifier
27482002
Citation
Heydari B, Abdullah S, Pottala JV, Shah R, Abbasi S, Mandry D, Francis SA, Lumish H, Ghoshhajra BB, Hoffmann U, Appelbaum E, Feng JH, Blankstein R, Steigner M, McConnell JP, Harris W, Antman EM, Jerosch-Herold M, Kwong RY. Effect of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial Infarction: The OMEGA-REMODEL Randomized Clinical Trial. Circulation. 2016 Aug 2;134(5):378-91. doi: 10.1161/CIRCULATIONAHA.115.019949.
Results Reference
result
PubMed Identifier
31948661
Citation
Fujikura K, Heydari B, Ge Y, Kaneko K, Abdullah S, Harris WS, Jerosch-Herold M, Kwong RY. Insulin Resistance Modifies the Effects of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial Infarction (from the OMEGA-REMODEL Randomized Clinical Trial). Am J Cardiol. 2020 Mar 1;125(5):678-684. doi: 10.1016/j.amjcard.2019.11.032. Epub 2019 Dec 9.
Results Reference
derived
PubMed Identifier
31532795
Citation
Kwong RY, Heydari B, Ge Y, Abdullah S, Fujikura K, Kaneko K, Harris WS, Jerosch-Herold M, Antman EM, Seidman JG, Pfeffer MA. Genetic profiling of fatty acid desaturase polymorphisms identifies patients who may benefit from high-dose omega-3 fatty acids in cardiac remodeling after acute myocardial infarction-Post-hoc analysis from the OMEGA-REMODEL randomized controlled trial. PLoS One. 2019 Sep 18;14(9):e0222061. doi: 10.1371/journal.pone.0222061. eCollection 2019.
Results Reference
derived

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Effect of High Dose Fish Oil Supplementation After Recent Heart Attack Using Magnetic Resonance Imaging

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