Evidence supporting the use of: EPA (eicosapentaenoic acid)
For the health condition: Angina

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Eicosapentaenoic acid (EPA), an omega-3 polyunsaturated fatty acid found in fish oil, has been studied for its potential cardiovascular benefits, including in patients with angina pectoris. The rationale for using EPA in angina is primarily based on its anti-inflammatory, anti-thrombotic, and endothelial function-modulating effects, which could theoretically improve coronary blood flow and reduce ischemic events. Several epidemiological studies have associated higher omega-3 intake with reduced cardiovascular morbidity and mortality, but specific evidence for EPA’s effect on angina symptoms is limited.

Randomized controlled trials (RCTs) examining omega-3 supplementation (often a combination of EPA and DHA) have shown mixed results. Some studies suggest a modest reduction in cardiovascular events, particularly in populations with high baseline risk or low dietary fish intake. However, very few trials have directly studied EPA (as opposed to general fish oils) for relief of angina symptoms or reduction of angina attacks. The JELIS trial (2007) demonstrated that high-dose pure EPA, when added to statins, reduced major coronary events in Japanese patients with hypercholesterolemia, including those with prior coronary artery disease, but it did not specifically measure angina frequency.

Current guidelines do not specifically recommend EPA for the treatment of angina, but some clinicians may use it as adjunct therapy for overall cardiovascular risk reduction. The evidence directly supporting its use for angina symptoms is therefore weak (rated 2/5), with most support coming from general cardiovascular protection rather than direct anti-anginal effects.

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