Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis
Khan SU, Lone AN, Khan MS, Virani SS, Blumenthal RS, Nasir K, Miller M, Michos ED, Ballantyne CM, Boden WE, Bhatt DL
EClinicalMedicine · 255 citas
Etiquetas de revisión
Vínculos de autores con la industriaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (clasificado por nuestro filtro de IA)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación independiente
- Autores
- Al menos un autor declara un vínculo económico con la industria
Según la declaración de financiación del texto completo.
Publicación
- Publicado
- 2021-07-08 · EClinicalMedicine · vol. 38 · pág. 100997
- Editorial
- Elsevier BV
- Citado
- 406 citas · más que el 99% de estudios similares · 11.1× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 69 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Fatty Acid Research and Health · Cardiac Valve Diseases and Treatments · Eicosanoids and Hypertension Pharmacology
- Palabras clave
- Medicine, Internal medicine, Meta-analysis, Mace, Myocardial infarction, Relative risk, Eicosapentaenoic acid, Docosahexaenoic acid, Cochrane Library, Randomized controlled trial, Adverse effect, Confidence interval, Polyunsaturated fatty acid, Fatty acid, Percutaneous coronary intervention
11 autores
- Safi Ullah Khan🇺🇸West Virginia University
- Ahmad Naeem Lone🇺🇸West Virginia University
- Muhammad Shahzeb Khan🇺🇸University of Mississippi Medical Center
- Salim S. Virani🇺🇸Michael E. DeBakey VA Medical Center; Baylor College of Medicine
- Roger Scott Blumenthal🇺🇸Johns Hopkins University; Johns Hopkins Medicine
- Khurram Nasir🇺🇸Houston Methodist
- Michael J. Miller🇺🇸University of Maryland, Baltimore; University of Maryland Medical Center
- Erin D. Michos🇺🇸Johns Hopkins University; Johns Hopkins Medicine
- Christie Mitchell Ballantyne🇺🇸Michael E. DeBakey VA Medical Center; Baylor College of Medicine
- William E. Boden🇺🇸Boston University; VA New England Healthcare System
- Deepak L. Bhatt🇺🇸 · autor de correspondenciaBrigham and Women's Hospital; Harvard University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
The effects of omega-3 fatty acids (FAs), such as eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, on cardiovascular outcomes are uncertain. We aimed to determine the effectiveness of omega-3 FAs on fatal and non-fatal cardiovascular outcomes and examine the potential variability in EPA vs. EPA+DHA treatment effects.
Methods
We searched EMBASE, PubMed, ClinicalTrials.gov, and Cochrane library databases through June 7, 2021. We performed a meta-analysis of 38 randomized controlled trials of omega-3 FAs, stratified by EPA monotherapy and EPA+DHA therapy. We estimated random-effects rate ratios (RRs) with (95% confidence intervals) and rated the certainty of evidence using GRADE. The key outcomes of interest were cardiovascular mortality, non-fatal cardiovascular outcomes, bleeding, and atrial fibrillation (AF). The protocol was registered in PROSPERO (CRD42021227580).
Findings
In 149,051 participants, omega-3 FA was associated with reducing cardiovascular mortality (RR, 0.93 [0.88-0.98]; p = 0.01), non-fatal myocardial infarction (MI) (RR, 0.87 [0.81-0.93]; p = 0.0001), coronary heart disease events (CHD) (RR, 0.91 [0.87-0.96]; p = 0.0002), major adverse cardiovascular events (MACE) (RR, 0.95 [0.92-0.98]; p = 0.002), and revascularization (RR, 0.91 [0.87-0.95]; p = 0.0001). The meta-analysis showed higher RR reductions with EPA monotherapy (0.82 [0.68-0.99]) than with EPA + DHA (0.94 [0.89-0.99]) for cardiovascular mortality, non-fatal MI (EPA: 0.72 [0.62-0.84]; EPA+DHA: 0.92 [0.85-1.00]), CHD events (EPA: 0.73 [0.62-0.85]; EPA+DHA: 0.94 [0.89-0.99]), as well for MACE and revascularization. Omega-3 FA increased incident AF (RR, 1.26 [1.08-1.48]). EPA monotherapy vs. control was associated with a higher risk of total bleeding (RR: 1.49 [1.20-1.84]) and AF (RR, 1.35 [1.10-1.66]).
Interpretation
Omega-3 FAs reduced cardiovascular mortality and improved cardiovascular outcomes. The cardiovascular risk reduction was more prominent with EPA monotherapy than with EPA+DHA.
Funding
None.
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