Daan Kromhout, et al. NEJM epub August 29, 2010

Screening, Randomization, and Follow-up Daan Kromhout, et al. NEJM epub August 29, 2010

Baseline Characteristics of the Patients, According to Study Group* *Plus–minus values are means ±SD. ALA denotes alpha-linolenic acid, DHA docosahexaenoic acid, EPA eicosapentaenoic acid, HDL high-density lipoprotein, and LDL low-density lipoprotein. † To convert the values for glucose to milligrams per deciliter, divide by 0.05551. ‡ To convert the values for cholesterol to milligrams per deciliter, divide by 0.02586. To convert the values for triglycerides to milligrams per deciliter, divide by 0.01129. § The body-mass index is the weight in kilograms divided by the square of the height in meters. Daan Kromhout, et al. NEJM epub August 29, 2010

Primary and Secondary Outcomes, According to n–3 Fatty-Acid Supplementation* Daan Kromhout, et al. NEJM epub August 29, 2010

Kaplan–Meier Curves for Primary and Secondary End Points Kaplan–Meier curves are shown for the cumulative incidence of major cardiovascular events (the primary end point) and fatal coronary heart disease (a secondary end point) among 4837 patients who had had a myocardial infarction and were assigned to receive a study margarine containing supplemental eicosapentaenoic acid (EPA) combined with docosahexaenoic acid (DHA), a margarine containing alpha-linolenic acid (ALA), a margarine containing both EPA–DHA and ALA, or a placebo margarine. Daan Kromhout, et al. NEJM epub August 29, 2010

Effect of EPA–DHA Supplementation and ALA Supplementation on the Primary End Point in Subgroups of Patients Effect of EPA–DHA Supplementation and ALA Supplementation on the Primary End Point in Subgroups of Patients. The primary end point of major cardiovascular events comprised fatal and nonfatal cardiovascular events and the cardiac interventions percutaneous coronary intervention and coronary-artery bypass grafting. Panel A shows the effects of supplementation with eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and Panel B the effects of supplementation with alpha-linolenic acid (ALA). Hazard ratios and 95% confidence intervals were calculated with the use of Cox proportionalhazards models. The size of each square is proportional to the number of patients; horizontal lines indicate 95% confidence intervals. P values are for the difference between active treatment and placebo. Daan Kromhout, et al. NEJM epub August 29, 2010

Cardiovascular Outcomes in Patients, According to the Presence or Absence of Diabetes and n–3 Fatty-Acid Supplementation Cardiovascular Outcomes in Patients, According to the Presence or Absence of Diabetes and n–3 Fatty-Acid Supplementation.* * Diabetes was considered to be present if a patient reported having received the diagnosis from a physician, was taking antidiabetic drugs, or had an elevated plasma glucose level (≥7.8 mmol per liter [140.5 mg per deciliter] in the case of patients who had fasted more than 4 hours or ≥11.1 mmol per liter [200.0 mg per deciliter] in the case of nonfasting patients). A total of 1014 patients had diabetes, and 3823 did not have diabetes. For these analyses, the two groups that received eicosapentaenoic acid (EPA) with docosahexaenoic acid (DHA) were combined and compared with the two groups that did not receive EPA–DHA (i.e., the groups that received either placebo or only alpha-linolenic acid [ALA]) . Similarly, the two groups that received ALA were combined and compared with the two groups that did not receive ALA (i.e., the groups that received placebo or only EPA–DHA). † The hazard ratios and 95% confidence intervals were calculated with the use of Cox proportional-hazards models. ‡ Major cardiovascular events comprised fatal and nonfatal cardiovascular events and the cardiac interventions percutaneous coronary intervention and coronary-artery bypass grafting. § Ventricular-arrhythmia–related events comprised sudden death, fatal and nonfatal cardiac arrest, and placement of implantable cardioverter-defibrillators. Daan Kromhout, et al. NEJM epub August 29, 2010