Oral administration of n-3 long-chain fatty acids reduce inflammatory response and improve clinical outcomes in patients with cardiovascular surgery

Background: Exacerbated post-surgery inflammation likely leads to adverse clinical outcomes (ACO). Given the antiinflammatory properties of n-3LC-PUFA potential beneficial effects are expected in patients with myocardial revascularization. Objective: To evaluate the effect of oral omega-3 LC-PUFA administration on the inflammatory response and ACO in subjects undergoing cardiovascular surgery. Methods: A double-blind randomized clinical trial was carried in 23 patients scheduled to myocardial revascularization. Twelve patients received orally 1.6g/day EPA + 0.8g DHA (O3-G) throughout 7 days starting 1-day previous surgery; 11 patients who received placebo were controls (CO-G). Intracellular expressions of IL-1beta, TNF-alpha, IL-6, IL-1ra, IL-10 and CD69 co-stimulatory molecule were measured in whole blood by flow-cytometry at 1-d before surgery, and at 2h, 24h, 48h and 7-day post-surgery. The development of infection, and cardiovascular and respiratory dysfunctions was evaluated daily; hospital stay was also assessed. Results: After adjusting by confounders, O3-G patients exhibited lower cytokine and CD69 expressions than CO-G. The frequency of ACO (33% vs. 82%, P=0.03), and the hospital stay (P<0.05) were also lower in O3-G than in CO-G. Conclusion: The oral administration of n-3 LC-PUFA reduces inflammatory response and protects surgical patients against adverse clinical outcomes.