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American Journal of Clinical Nutrition, Vol. 84, No. 6, 1554, December 2006
© 2006 American Society for Nutrition

LETTER TO THE EDITOR

Effects of n–3 fatty acids on arrhythmic events and mortality in the SOFA implantable cardioverter defibrillator trial

Ingeborg A Brouwer

Wageningen Centre for Food Sciences
Wageningen
The Netherlands
and
Division of Human Nutrition
Wageningen University
c/o Bomenweg 2
6703 HD Wageningen
The Netherlands
and
Institute for Health Sciences
Vrije Universiteit
Amsterdam
The Netherlands
E-mail: ingeborg.brouwer{at}wur.nl

Martijn B Katan

Institute for Health Sciences
Vrije Universiteit
Amsterdam
The Netherlands

Peter L Zock

Unilever Food and Health Research Institute
Vlaardingen
the Netherlands
and
Wageningen Centre for Food Sciences
Wageningen
The Netherlands
and
Division of Human Nutrition
Wageningen University
Wageningen
The Netherlands

Dear Sir:

We appreciate the extensive and timely review of the currently available evidence on n–3 fatty acids and cardiovascular disease as provided by Wang et al (1). However, they included data from our Study on Omega–3 Fatty Acids and Ventricular Arrhythmia (SOFA) trial (2) that are erroneous and not to be found in any of our presentations or publications. Wang et al mistook survival rate, ie, the percentage of patients still free from disease, for event rates, ie, the percentage of patients with disease. As we reported both on the website referred to by the authors [reference 32 in the article by Wang et al (1)] and in our full publication (2), 70% of patients who received fish oil survived without ventricular fibrillation or ventricular tachycardia compared with 67% of the patients in the placebo group. The hazard ratio for the primary endpoint, patients who died or had ventricular tachycardia or ventricular fibrillation, was 0.86 (95% CI: 0.64, 1.16) and not 1.04 (0.93, 1.17) as stated by Wang et al (1). In a subgroup of 342 (not 324) patients with myocardial infarction, event-free survival (not event rate) was 72% in the fish-oil group compared with 65% in the placebo group. Patients in the SOFA trial randomly received either 2 g fish oil (n = 273, not 278), which contained {approx}900 mg (not 2 g) very-long-chain n–3 fatty acids, or 2 g (not 3.4 g) of high oleic acid sunflower oil (n = 273, not 278). Eight patients in the fish-oil group died (6 of them from cardiac causes) compared with 14 patients (13 cardiac deaths) in the placebo group (2). We would greatly appreciate if the authors would publish a corrected Table to set the record straight.

ACKNOWLEDGMENTS

None of the authors had any conflict of interest.

REFERENCES

  1. Wang C, Harris WS, Chung M, et al. n-3 Fatty acids from fish or fish-oil supplements, but not {alpha}-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr 2006;84:5–17.[Abstract/Free Full Text]
  2. Brouwer IA, Zock PL, Camm AJ, et al. Effect of fish oil on ventricular tachyarrhythmia and death in patients with an implantable cardioverter. defibrillators. Results of the Study on Omega-3 Fatty Acids and Ventricular Arrhythmia (SOFA) randomized trial. JAMA 2006;295:2613–9.[Abstract/Free Full Text]




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