This article has no abstract so we have provided the first paragraph of the full text.

JELIS is the largest and longest omega-3 fatty acid intervention study yet reported. In this trial, more than 18,600 hypercholesterolemic men and women from Japan were followed for cardiac events for 5 years after being randomly assigned to receive statin monotherapy or a statin plus 1,800 mg of EPA ethyl esters. Although Japanese individuals already have an omega-3 fatty acid intake approximately eight times higher than is typical in Western cultures,1 the addition of EPA to statin therapy resulted in a 19% reduction in major adverse cardiac events. The primary effects of EPA were seen not on mortality or sudden death (for which there were few events and no differences between treatment groups), but on 'softer' end points, such as unstable angina and nonfatal cardiac events. The effect of EPA was similar in both the primary and secondary-prevention setting, although statistically significant only in the latter. EPA had no significant impact on serum lipid parameters.