Thank you hitchy...
Informed posters on this site know EPA/AA ratio is inversely correlated with CVD risk...This has held up in every legitimate outcome trial, population studies and is consistent with what has been demonstrated in scientific research...DHA probably does have some role in resolvins, but is principally a structural molecule vital to cell membranes and neural transmission.
Despite the obfuscation created by the statistical method junkies, we can use our own brains and gain some useful information from JELIS...
Some cold hard facts...In the JELIS secondary prevention group (patients with documented CVD); the group that most closely resembles R-I enrollees, 1.8gm/day of EPA resulted in a significant 19% reduction in MACE..This treatment also resulted in non sig reductions of 25%, 25% and 18% in coronary death, MIs (heart attacks) fatal and non fatal, and non fatal coronary events..
The reason for the non significance was simply due to the fact there were not enough events in these latter groups. There were.only 364 events in the entire secondary group. What we can anticipate in R-I is that the underlying risk of CVD is at minimum 2.5 times higher and probably closer to 3 times higher in R-I than it was in J secondary. . Consistent with the EPA/AA theory the underlying EPA/AA ratio in R-I is over 5 time lower than JELIS secondary. We know that 4gms/day of EPA in the active R-I arm will result in EPA/AA ratios which are seen in the JELIS secondary active arm...The conclusion is inescapable..The RRR MACE reduction must be greater than 20%...but there is more..
A wide misconception of the JELIS results is that EPA cut the risk of angina, but was relatively ineffective against more serious MACE, like MIs. This misconception grew out of the fact that of the category of individual events, angina was by far the most common..There were enough angina events to determine the 19% reduction in angina was statistically significant...The reality is that the 25% event reductions were actually higher in categories of more serious MACE events like MIs than the 19% risk reduction seen in angina.. But since there were fewer MIs, there were not enough to determine significance.
In R-I we should have around 1100 events for the interim look in late September...That is just over three time the number of events in the JELIS secondary..Furthermore the greater discrepancy between the EPA/AA ratios in R-I should convert to higher RRR in the individual MACE events, (40% would not be a surprise) so the chance we will see statistically significant reductions at this first interim is very high.
":>) JL
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