In Jelis the AA/EPA ratio decreases from a an already optimal 1.6 to 0.8 and yet provided a 19% MACE RRR, which was quite astonishing IMO, as you would not expect to see any difference between those already optimal levels. For such healthy population you would not expect a significant difference in deaths between the two arm and as a matter of fact very few died of CDV in this trial and we know that in general Japan has a very low CVD mortality. Why? Because they have a very low AA/EPA ratio!
From various readings it appears that average US citizens have an AA/EPA ratio above 15, 10 -15 times bigger ratio than avg Japanese. It is not astonishing that in USA CVD is the first cause of death by far and that RIT MACE composite rate is almost 10 times bigger than Jelis (4.7% pa vs 0.6% p.a)
RIT was designed to try and achieve (more than double Jelis dosage) a AA/EPA ratio closer to Jelis (also because the more EPA incraseas the more AA reduces as they both compete for the same receptors, so EPA intake has a double effect on numerator and denominator of the AA/EPA ratio) and we know that this is going to make a big difference in terms of CVD mortality and MACE from countless published studies we had in the last few years.
These are the facts, the rest is noise.