Effects of purified eicosapentaenoic acid versus mixed eicosapentaenoic/docosahexaenoic acid pharmacotherapies on coronary plaque volume: network meta-analysis of prospective coronary imaging trials

BACKGROUND: Reduced cardiovascular event risk is observed with eicosapentaenoic acid (EPA), but EPA mixed with docosahexaenoic acid (EPA/DHA) does not show consistent benefit. Comparative effects of EPA versus EPA/DHA on coronary plaque remain unclear. METHODS: We systematically reviewed trials measuring coronary plaque volume in patients randomised to statin + EPA or statin + EPA/DHA therapy compared to statin monotherapy, and used network meta-analysis to compare percent change in total and lipid coronary plaque volumes on these treatments. RESULTS: = 0.38). CONCLUSIONS: EPA but not EPA/DHA is associated with reductions in coronary plaque burden when given as adjunct to statins in patients with coronary artery disease.