Omega-3 fatty acids in high-risk cardiovascular patients: a meta-analysis of randomized controlled trials
Filion KB, El Khoury F, Bielinski M, Schiller I, Dendukuri N, Brophy JM
BMC cardiovascular disorders · 85 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Universidad u hospital
- McGill University
- Universidad u hospital
- McGill University Health Centre
Según 2 financiadores declarados y la declaración de financiación del texto completo.
Publicación
- Publicado
- 2010-06-03 · BMC Cardiovasc Disord · vol. 10 · número 1 · pág. 24
- Editorial
- BioMed Central
- Citado
- 124 citas · más que el 91% de estudios similares · 2.5× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 65 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Fatty Acid Research and Health · Nutritional Studies and Diet · Lipoproteins and Cardiovascular Health
- Palabras clave
- omega-3 fatty acids, cardiovascular disease, high cardiovascular risk patients, all-cause mortality, coronary restenosis, percutaneous coronary intervention, secondary prevention, omega-3 supplementation, study heterogeneity
- MeSH
- humans, cardiovascular diseases, coronary restenosis, fatty acids, omega-3, fish oils, risk, survival analysis, aged, middle aged, female, male, randomized controlled trials as topic
6 autores
- Kristian B. Filion🇨🇦McGill University
- Fouad El Khoury🇨🇦McGill University Health Centre; McGill University
- Michael Bielinski🇨🇦McGill University Health Centre; McGill University
- Ian Schiller🇨🇦McGill University
- Nandini Dendukuri🇨🇦McGill University Health Centre; McGill University
- James M. Brophy🇨🇦 · autor de correspondenciaMcGill University Health Centre; McGill University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Multiple randomized controlled trials (RCTs) have examined the cardiovascular effects of omega-3 fatty acids and have provided unexplained conflicting results. A meta-analysis of these RCTs to estimate efficacy and safety and potential sources of heterogeneity may be helpful.
Methods
The Cochrane library, MEDLINE, and EMBASE were systematically searched to identify all interventional trials of omega-3 fatty acids compared to placebo or usual diet in high-risk cardiovascular patients. The primary outcome was all-cause mortality and secondary outcomes were coronary restenosis following percutaneous coronary intervention and safety. Meta-analyses were carried out using Bayesian random-effects models, and heterogeneity was examined using meta-regression.
Results
A total of 29 RCTs (n = 35,144) met our inclusion criteria, with 25 reporting mortality and 14 reporting restenosis. Omega-3 fatty acids were not associated with a statistically significant decreased mortality (relative risk [RR] = 0.88, 95% Credible Interval [CrI] = 0.64, 1.03) or with restenosis prevention (RR = 0.89, 95% CrI = 0.72, 1.06), though the probability of some benefit remains high (0.93 and 0.90, respectively). However in meta-regressions, there was a >90% probability that larger studies and those with longer follow-up were associated with smaller benefits. No serious safety issues were identified.
Conclusions
Although not reaching conventional statistical significance, the evidence to date suggests that omega-3 fatty acids may result in a modest reduction in mortality and restenosis. However, caution must be exercised in interpreting these benefits as results were attenuated in higher quality studies, suggesting that bias may be at least partially responsible. Additional high quality studies are required to clarify the role of omega-3 fatty acid supplementation for the secondary prevention of cardiovascular disease.
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