Protection Against Incidences of Serious Cardiovascular Events Study with Daily Fish Oil Supplementation in Patients on Dialysis (PISCES)
Bibliographic record
Abstract
Background: Cardiovascular (CV) events occur frequently and is the leading cause of mortality in patients receiving maintenance hemodialysis (HD), yet effective preventive therapies remain limited. Omega-3 polyunsaturated fatty acids (n-3 PUFA)- eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have shown potential CV benefits in the general population, although their efficacy in the HD population is uncertain. Methods: PISCES was a multicenter double-blind placebo-controlled RCT evaluating the effect of daily oral supplementation with 4 g of n-3 PUFA (1.6 g EPA, 0.8 g DHA) vs placebo in 1228 adults on maintenance HD (26 sites) x 3.5 years. The primary endpoint was the rate of all serious CV events (CV death, non-fatal myocardial infarction, stroke, peripheral vascular disease requiring amputation). Secondary outcomes included the primary outcome plus all-cause mortality and individual components of the primary outcome. Results: The rate of the primary outcome was significantly lower in the n-3 PUFA group (0.31/1000 days) compared to placebo (0.61/1000 days) (Fig 1); HR 0.57 (95% CI: 0.47-0.70), p<0.0001 (Fig 2). The rate of the secondary outcome of CV events and all-cause mortality was significantly reduced (HR 0.77; 95% CI:0.65–0.90; p<0.0001). Benefits were consistent among those with (HR 0.50; 95% CI: 0.37-0.67] and without (HR 0.55; 95% CI: 0.40-0.76; p < 0.000) prior CV events. Each component of the primary outcome occured less frequently in n-3 PUFA group (Fig 2). There were no safety signals. Conclusion: The rate of serious CV events was significantly lower in patients on maintenance HD who received daily n-3 PUFA compared with placebo. Funding: Other NIH Support - Heart and Stroke Foundation of Canada (G-15- 0009388), Lawson Health Research Institute, Peter Munk Cardiac Care Innovation Fund (CMT-1516-237), Kidney CARE Network International, National Health and Medical Research Council (APP1123392) (NHMRC, Australia). Personnel award (Dr. Charmaine Lok) - Heart and Stroke Foundation (#7511-A), Ontario Provincial Office. Private donation - Mr. Alexander Epstein., Commercial Support - In Kind contribution from DSM (previously Ocean Nutrition Canada), Private Foundation Support, Government Support - Non-U.S.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".