The JELIS study had reductions in all areas but after adjustments the P values only showed that the Angina was proven to be statistically significant in the entire population. Even though there were reductions in other areas the P values were not statistically significant and in science p values is what matters. In the whole population there were no statistically significant differences except in Angina.
From study analysis at medscape
Among the primary endpoint components, a 24% reduction in unstable angina in the EPA group was the only significant difference compared with the control group.
Analysis of combined endpoints showed a significant 19% reduction in nonfatal coronary events, defined as nonfatal MI, unstable angina, or CABG/PCI, in the EPA group vs controls (P = .015). There was no significant difference in all-cause mortality between the 2 treatment groups.
When you break out the subgroups you see if you had no history of coronary artery disease:
In the 14,981 subjects with no history of coronary artery disease (CAD), major coronary events were reduced by 18% in the EPA group vs the controls, although this difference was not significant. Nonsignificant reductions were also seen in nonfatal MI, unstable angina, and CABG/PCI, and in combined endpoints of coronary death or MI, fatal or nonfatal MI, and nonfatal coronary events.
VS if you did:
Compared with the primary prevention subgroups, the 3664 subjects with a history of CAD tended to be on antiplatelet drugs, antihypertensive agents, and nitrates, and in these secondary prevention patients, EPA was associated with a significant 19% reduction in major coronary events compared with the control group (Table 3). Unstable angina was also significantly reduced in the EPA group, by 28%. Nonsignificant reductions were seen in fatal MI, nonfatal MI, and CABG/PCI and in combined endpoints.
After adjustment for age, gender, and prevention strategy, an inverse association was found between the risk of major coronary events and EPA/arachidonic acid ratio, suggesting that the effect of EPA may be antithrombotic or anti-inflammatory, or the effect may be such that it increases the stability of the atherosclerotic plaque, Prof. Yokoyama suggested.
AHA-designated discussant Beatriz L Rodriguez, MD, PhD (University of Hawaii, Honolulu), observed that although the overall reduction in major coronary events in JELIS was an "interesting" result, "there was no strong evidence that EPA affects mortality one way or another." It would be of great value, she suggested, for the study to continue the follow-up in order to reach an assessment of total mortality.
