Table 3.20 Effects of omega-3 fatty acids on platelet aggregation in randomized trials (4 to 15 weeks)

Author, YearOmega-3 Fatty Acid Arma ControlsResults2 Qualityc Applicabilityd
NSourceg/dNSourceMethod, UnitBaseNet Δ P SummaryJadadAllocation Conceal
Hansen, 1993b14eWomenCod liver oilED5.314 e No oilCollegen 0.5 μg/ml, %47.0+1.2NSC1UnGENII
Collagen 4 μg/ml, %95.0+1.4NS
ADP 2.5 μmol/L, %81.0-4.3NS
20e Men20e Collagen 0.5 μg/ml, %56.0-24.7<.01
Collagen 4 μg/ml, %95.0-2.6NS
ADP 2.5 μmol/L, %76.0-5.9NS
Haines, 1986 19Fish oilED4.622Olive oilCollagan 1 μg/ml, Unit49.3-3.1NSB2AdIDDMII
Collagen 10 μg/ml, Unit59.1+2.2NS
Sirtori, 1992 12e Fish oilED4.512e No oilCollagen AC50, mg/Lf 0.35+0.05NSC2UnDysLipII
Iloprost IC50, nmol/Lg 0.65+0.07NS
Hendra, 1990 35Fish oilED3.032Olive oilSpontaneous 10 min, h 77.3+3.2.06B4UnDM III
Spontaneous 20 min, h 70.3+4.4.02
Spontaneous 30 min, h 67.4+4.7.02
Spontaneous 60 min, h 62.9+4.2.02
Salonen, 1987 20Fish oilED2.724Olive oilADP 2.3–9.0 μmol/L Aggregation extent, mV16.2+3.3NSB3UnGENII
ADP 2.3–9.0 μmol/L Aggression velocity, mV/sec0.16+0.05NS
Plant Oils
Kwon, 1991 16Canola oil dietT8–9%i 14Safflower oil dietCollagen 1 mg/L Maximum aggregation, Ω43.50NSC1UnDysLipII
Collagen 2 mg/L Maximum aggregation, Ω46.3+1.5NS
Junker, 2001 18Rapeseed oil dietT2.5%j 40Olive or Sunflower oil dietADP 0.5 μmol/L,%7.8+19.7k NSC1UnGENI
ADP 2 μmol/L, %27.1+31.4k NS
Adernaline 1μmol/L, %82.3+9.9k NS
Adernaline 4 μmol/L, %85.17.8k NS
Spontaneous7.2+1.3k NS
Freese, 1994 20Rapeseed oil dietA2.3%j 20Trisun Sunflower oil diet L ADP 1 μmol/L slope, %/min19.9-5.4m .004C1UnGENIII
ADP 2 μmol/L slope,%/min43.4-9.5m .002
ADP 3 μmol/L slope, %min56.4-6.6m .001
Thrombin 0.12 NIH/Ml slope, %/min n 20.7-1.0NS
Thrombin 0.15 NIH/mL slope, %/minn 33.5-3.8.03
Thrombin 0.18 NIH/mL slope, %/minn 36.7-3.0m .02
Freese, 1997a16Fish oilED5.2----ADP 1 μmol/L, %/min34.4+3.8o ndp C3UnGENII
ADP 2 μmol/L, %/min60.0+4.6o ndp
ADP 3 μ,ol/L, %/min72.3-0.7o ndp
Collagen 0.5 μmol/L, %/min53.3-22.2o ndp
Collagen 1 μg/mL, %/min81.2-2.2o ndp
Collagen 3 μg/mL, %/min99.6-3.4o ndp
14Linseed oilA5.9ADP 1 μmol/L, %/min34.8-0.7o ndp
ADP 2 μmol/L, %/min56.3-1.6o ndp
ADP 3 μmol/L, %/min68.8-5.0o ndp
Collagen 0.5 μg/mL, %/min44.8-9.6o ndp
Collagen 1 μg/ml, %/min78.6-1.8o ndp
Collagen 3 μg/mL, %/min94.3+4.1o ndp
Agren, 1997 14Fish oilED2.314No oilADP 2 μmol/L, %Tn 49.9-5.8NSB3UnGENIII
ADP 5 μmol/L, %Tn 74.2-9.3NS
Collagen 50 μg/mL, %Tn 51.3-31.2<.05
14Algae DHA oilD1.7ADP 2 μmol/L, %Tn 37.2+7.5NS
ADP 5 μmol/L, %Tn 64.5-0.1NS
Collagen 50 μg/mL, %Tn 39.3+13.7NS
13Fatty Fish dietED1.1ADP 2 μmol/L, %Tn 35.1+4.6NS
ADP 5 μmol/L, %Tn 70.0-2.9NS
Collagen 50 μg/mL, %Tn 66.1-20.7<.05
Wensing, 1999 14Fish oil shorteningED1.611Sunflower oilADP 1.5 μmol/L, Va, %q 48.2+6.7NSB2UnGENII
ADP 1.5 μmol/L Imax, %r 69.6+2.2NS
Collagen 1.0 μg/mL Va, %q 46.5-6.2NS
Collegan 1.0 μg/mL Imax, % r 65.7+2.8NS
13Linseed oil shorteningA6.5ADP 1.5 μmol/L Va, %q 52.9-1.9NS
ADP 1.5 μmol/L Imax, %r 73.3-15.6NS
Collagen 1.0 μg/mL Va, %q 40.2-3.8NS
Collagen 1.0 μg/mL Imax, %r 50.2+10.4NS

nd = no data


A = ALA; D = DHA; E = EPA; ED = EPA+DHA; T = Total omega-3 fatty acids.


Base = baseline level in treatment arm Net Δ = net difference in change in omega-3 fatty acids arm compared with the change in control in control arm, see Methods; P = P value of difference between treatment and control arms; NS = not statistically significant.


A = good quality; B = fair quality; C = poor quality; Jadad = Jadad Score (0-5, based on randomization, double blinding, and dropouts); Ad = adequate allocation concealment; In = inadequate allocation concealment; Un = allocation concealment unclear. See Methods.


CVD = history of cardiovascular disease; DM I/II = diabetes mellitus type 1 or 2; DysLip = dyslipidemia; GEN = general, healthy population; N/IDDM = (non-) insulin dependent diabetes mellitus. I = broadly applicable; II = applicable to sub-group; III = narrow applicability. See Methods.


Cross-over study.


Concentration of collagen giving a 50% decrease in optical density.


Concentration of Iloprost resulting in 50% inhibition of platelet aggregation.


Percent platelets remaining after aggregation.


Percent of total methyl esters in diet.




Difference compared to average change in 2 control groups.


High linoleic acid (18:2 n-6) oil.


No significant effect compared to baseline. Significant increase compared to Trisun oil, which increased platelet aggregation rate.


No definition of unit provided.


Pre-post difference (not compared to control).


Not significant between treatments.


Aggregation velocity.


Maximal velocity.

From: 3, Results

Cover of Effects of Omega-3 Fatty Acids on Cardiovascular Risk Factors and Intermediate Markers of Cardiovascular Disease
Effects of Omega-3 Fatty Acids on Cardiovascular Risk Factors and Intermediate Markers of Cardiovascular Disease.
Evidence Reports/Technology Assessments, No. 93.
Balk E, Chung M, Lichtenstein A, et al.

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