Fish oil supplementation does not increase bleeding tendency

OSLO, NORWAY. A group of Norwegian medical researchers reports that fish oil supplementation does not increase the bleeding tendency in heart disease patients receiving aspirin or warfarin. The study involved 511 patients who had undergone coronary artery bypass surgery. On the second day after the operation half the patients were assigned in a random fashion to receive 4 grams of fish oil per day (providing 2 g/day of eicosapentaenoic acid, 1.3 g/day of docosahexaenoic acid, and 14.8 mg/day of vitamin E). At the same time the patients were also randomized to receive either 300 mg of aspirin per day or warfarin aimed at achieving an INR of 2.5-4.2. The patients were evaluated every 3 months and questioned about bleeding episodes for the duration of the 9-month study.

The researchers concluded that fish oil supplementation did not result in a statistically significant increase in bleeding episodes in either the aspirin group or in the warfarin group. They also found no significant long-term effects of fish oil on common parameters of coagulation and fibrinolysis. They noted that the blood levels (serum phospholipid levels) of eicosapentaenoic acid and docosahexaenoic acid increased by 140% and 14% respectively in the patients taking fish oil. The serum triglyceride levels decreased by 19.1% in the fish oil group while no significant change was observed in the remainder of the patients. NOTE: This study was partially funded by Pronova Biocare AS (a fish oil manufacturer) and Nycomed Pharma AS.
Eritsland, J., et al. Long-term effects of n-3 polyunsaturated fatty acids on haemostatic variables and bleeding episodes in patients with coronary artery disease. Blood Coagulation and Fibrinolysis, Vol. 6, 1995, pp. 17-22

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