Response to Letters Regarding Article, “OMEGA, A Randomized, Placebo-Controlled Trial to Test the Effect of Highly Purified Omega-3 Fatty Acids on Top of Modern Guideline-Adjusted Therapy After Myocardial Infarction”

The aim of the OMEGA trial was to test the prognostic effect of supplementation with highly concentrated omega-3 fatty acids (Ω) in addition to current guideline-adjusted therapy of acute myocardial infarction and secondary prevention. 1 In comparison with the GISSI trial,2 the markedly improved therapeutic interventions resulted in unexpected low event rates, leading to an underpowering of the study with respect to the primary end point, sudden cardiac death (SCD). This has been discussed within the publication, and these low event rates may be difficult to be topped by any additional treatment within the course of secondary prevention. The suggestion that a prolongation of the treatment period could have revealed the long-term benefits of Ω has to be discussed against the background that, in acute myocardial infarction patients with left ventricular dysfunction, the rate of SCD …