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Omega-3 Fatty Acids for Prevention of Post-Operative Atrial Fibrillation (OPERA)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00970489
Recruitment Status : Completed
First Posted : September 2, 2009
Results First Posted : April 10, 2017
Last Update Posted : April 10, 2017
The OPERA Investigators
Information provided by (Responsible Party):
Dariush Mozaffarian, MD, Brigham and Women's Hospital

Brief Summary:
This is a large multi-center study to examine whether peri-operative intake of n-3 polyunsaturated fatty acids (PUFA) will reduce the occurrence of post-operative atrial fibrillation or flutter (AF) in patients undergoing cardiac surgery (CS).

Condition or disease Intervention/treatment Phase
Atrial Fibrillation Drug: Omega -3 fatty acids Drug: Placebo Phase 3

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1516 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Official Title: (OPERA)Randomized Clinical Trial to Examine Whether Peri-operative Intake of n-3 Polyunsaturated Fatty Acids Will Reduce the Occurrence of Post-operative Atrial Fibrillation in Patients Undergoing Cardiac Surgery
Study Start Date : August 2010
Actual Primary Completion Date : May 2012
Actual Study Completion Date : June 2012

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: Omega-3 fatty acid capsules Drug: Omega -3 fatty acids
10g dose of oral omega-3 fatty acid capsules over 3-5 days before surgery (or 8 g over 2 days before surgery), including the morning of surgery, followed by 2g/d after surgery for 10 days, or until discharge, whichever occurs first.

Placebo Comparator: Olive Oil capsule Drug: Placebo
Olive Oil capsules

Primary Outcome Measures :
  1. Any First Post-op Atrial Fibrillation or Flutter (AF) [ Time Frame: up to 10 days post-surgery or discharge, whichever sooner ]
    Primary: Occurrence of post-CS AF (atrial fibrillation or flutter) of at least 30 seconds duration and confirmed by rhythm strip or 12-lead ECG. This will include definite AF and probable AF (SVT likely to be AF depending on rate and other characteristics).

Secondary Outcome Measures :
  1. Post-op Af [ Time Frame: up to 10 days post-surgery or discharge, whichever sooner ]
    Secondary AF endpoints included post-op AF that was sustained (>1 hour), symptomatic, or treated with pharmacological or electrical cardioversion; post-op AF excluding atrial flutter; time to first post-op AF; and the number of post-op AF episodes per patient. OPERA also evaluated the total number of in-hospital days in which any post-op AF, including sustained post-op AF, was present; and the proportion of in-hospital days free of any post-op AF. All potential episodes of post-op AF and other tachyarrhythmias were reviewed and adjudicated by a centralized Events Committee of cardiac electrophysiologists. Additional endpoints included resource utilization, major adverse cardiovascular events (MACE), arterial thromboembolism, and 30-day mortality.

  2. Other Arrhythmias [ Time Frame: up to 10 days post-surgery or discharge, whichever sooner ]
    • The first 3 suspected episodes of atrial fibrillation or flutter of at least 30 sec duration following randomization were documented, including the following information:

      • Printed or digital rhythm strip and/or 12-lead ECG.
      • Recording of time of onset and time of cessation.
      • Additional documentation of temporally associated signs of symptoms, such as new or worsening chest pain, shortness of breath, or lightheadedness; drop in blood pressure requiring escalation of fluid or pressor treatment; or need for electrical or pharmacologic cardioversion.
    • The first suspected episode of each of other supraventricular or unknown narrow-complex tachycardia of at least 30 sec duration following randomization was also documented.

  3. Other Endpoints [ Time Frame: up to 10 days post-surgery or discharge, whichever sooner ]
    1. Number of days in the ICU, of telemetry monitoring, and of total hospital stay.
    2. Non-AF arrhythmias of at least 30 sec duration, including non-AF-SVT, ventricular tachycardia (VT), and ventricular flutter (VF), assessed and adjudicated by the Events Committee.
    3. MACE: Combined total mortality, myocardial infarction, and stroke.
    4. Bleeding, assessed by (a) chest tube output in the 24 hour period following surgery and (b) total number of packed red blood cell (RBC) transfusions from enrollment to end of treatment (hospital discharge or post-op day 10).
    5. Significant adverse events: Discontinuation of study treatment, at the discretion of the treating physicians, for suspected significant allergic reaction, severe gastrointestinal intolerance, significant bleeding, or other side effects requiring discontinuation.
    6. Thirty-day mortality assessed
    7. One-year mortality assessed

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Age 18 years or over
  • Scheduled for CS on the following day or later, including coronary artery bypass, valve surgery, any other open cardiac surgery (i.e., that includes opening of the pericardium), or any combination.
  • Sinus rhythm on current ECG (sinus bradycardia, sinus tachycardia, and ectopy are acceptable).

Exclusion Criteria:

  • Regular use (3 or more days/week) of fish oil within the past 4 weeks.
  • Known allergy or intolerance to fish oil or corn oil.
  • Currently pregnant.
  • Unable to provide informed written consent.
  • Current or planned cardiac transplant or LVAD

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00970489

United States, Massachusetts
US, Italy and Argentina
Boston, Massachusetts, United States, 02115
Sponsors and Collaborators
Brigham and Women's Hospital
The OPERA Investigators
Principal Investigator: Dariush Mozaffarian, MD DrPH Harvard School of Public Health
Principal Investigator: Roberto Marchioli, MD Laboratory of Clinical Epidemiology of Cardiovascular Disease Department of Clinical Pharmacology and Epidemiology Consorzio Mario Negri Sud Via Nazionale 8/A S. Maria Imbaro (Chieti), 66030 ITALY

Publications automatically indexed to this study by Identifier (NCT Number):

Responsible Party: Dariush Mozaffarian, MD, Associate Professor of Medicine, Brigham and Women's Hospital Identifier: NCT00970489     History of Changes
Other Study ID Numbers: IND-104364
First Posted: September 2, 2009    Key Record Dates
Results First Posted: April 10, 2017
Last Update Posted: April 10, 2017
Last Verified: February 2017

Keywords provided by Dariush Mozaffarian, MD, Brigham and Women's Hospital:
atrial fibrillation
fish oil

Additional relevant MeSH terms:
Atrial Fibrillation
Arrhythmias, Cardiac
Heart Diseases
Cardiovascular Diseases
Pathologic Processes