Evidence supporting the use of: Eicosapentaenoic acid
For the health condition: Congestive Heart Failure

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Eicosapentaenoic acid (EPA), an omega-3 polyunsaturated fatty acid found primarily in marine oils, has been studied for its potential benefits in cardiovascular conditions, including congestive heart failure (CHF). The scientific rationale for EPA use in CHF centers on its anti-inflammatory, anti-arrhythmic, and endothelial function-improving properties. Several clinical trials and meta-analyses have explored the effects of omega-3 fatty acids (often EPA and DHA combined) in heart failure patients.

The most influential randomized controlled trial is the GISSI-HF (Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico–Heart Failure) study, which enrolled over 6,000 patients with chronic heart failure. The trial found that supplementation with 1 gram daily of omega-3 fatty acids led to a modest but statistically significant reduction in all-cause mortality and cardiovascular hospitalizations compared to placebo. While the trial included both EPA and DHA, subgroup analysis suggested that EPA may be a major contributor to observed benefits.

Despite these findings, the benefit size is modest, and not all studies have shown positive results. Recent guidelines from major heart associations (e.g., AHA, ESC) suggest that omega-3 supplementation may be considered in selected heart failure patients, but it is not a first-line therapy. The evidence is thus moderate (rated 3/5), driven by large RCTs and meta-analyses, but limited by modest effect and heterogeneity in study outcomes.

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