Inflammation
High-dose omega-3 fatty acids cut arterial inflammation by 4% in patients with elevated Lp(a), an EPA-driven effect, a pilot PET/CT study of 12 patients (J Clin Lipidol 2023)
Original title: Improved arterial inflammation with high dose omega-3 fatty acids in patients with elevated lipoprotein(a): Selective effect of eicosapentaenoic acid?
In a pilot study of 12 patients with elevated Lp(a) (>0.5 g/L) and stable coronary artery disease on cholesterol-lowering treatment, high-dose omega-3 fatty acids (3.6 g/day) were given for 12 weeks, with arterial inflammation assessed by 18F-fluorodeoxyglucose PET/CT before and after. Omega-3 treatment significantly reduced triglycerides (-17%, P<0.01), Lp(a) (-5%, P<0.01), and aortic maximum standardised uptake value (SUVmax, a marker of arterial inflammation, -4%, P<0.05). The reduction in SUVmax correlated inversely with on-treatment eicosapentaenoic acid (EPA) levels (r=-0.750, P<0.01), but not with docosahexaenoic acid or triglyceride levels. The findings suggest high-dose omega-3 fatty acids, particularly EPA, reduce arterial inflammation in patients with elevated Lp(a), independent of their modest lipid-lowering effect.
Original abstract
Elevated lipoprotein(a) [Lp(a)] is a causal risk factor for atherosclerotic cardiovascular disease. However, there are no approved and effective treatments for lowering Lp(a) and the associated cardiovascular risks. Omega-3 fatty acids (ω-3FAs), primarily eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have both triglyceride-lowering and anti-inflammatory properties. This pilot study investigated the effect of high dose ω-3FAs (3.6 g/day) on arterial inflammation in 12 patients with elevated Lp(a) (> 0.5 g/L) and stable coronary artery disease (CAD) receiving cholesterol-lowering treatment. Arterial inflammation was determined using 18F-fluorodexoyglucose positron emission tomography/computed tomography before and after 12-weeks intervention. ω-3FAs significantly lowered plasma concentrations of triglycerides (-17%, p < 0.01), Lp(a) (-5%, p < 0.01) as well as aortic maximum standardized uptake value (SUVmax) (-4%, p < 0.05). The reduction in SUVmax was significantly inversely associated with average on-treatment EPA (r = -0.750, p < 0.01), but not DHA and triglyceride, concentrations. In conclusion, high dose ω-3FAs decrease arterial inflammation in patients with elevated Lp(a) and stable CAD, which may involve a direct arterial effect of EPA.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.