Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis
Gencer B, Djousse L, Al-Ramady OT, Cook NR, Manson JE, Albert CM
Circulation · 113 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
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- National Cancer Institute
- Gobierno
- National Center for Complementary and Integrative Health
- Gobierno
- NCCIH NIH HHS
- Gobierno
- NCI NIH HHS
- Gobierno
- NHLBI NIH HHS
- Subvenciones
- National Cancer Institute (U01CA138962); National Heart, Lung, and Blood Institute (R01 HL116690); National Cancer Institute (R01CA138962); National Center for Complementary and Integrative Health (R01AT011729)
Según 6 financiadores declarados.
Publicación
- Publicado
- 2021-10-07 · Circulation · vol. 144 · número 25 · págs. 1981–1990
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 150 citas · más que el 97% de estudios similares · 4.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 30 trabajos
- Acceso
- Acceso abierto (revista híbrida) · PUBLIC-DOMAIN
- Áreas de investigación
- Fatty Acid Research and Health · Atrial Fibrillation Management and Outcomes · Cardiac Health and Mental Health
- Palabras clave
- marine omega-3 fatty acids, omega-3 supplementation, atrial fibrillation, atrial fibrillation risk, dose-response relationship, cardiovascular outcomes, randomized controlled trials, cardiovascular disease prevention, omega-3 deficiency
- MeSH
- animals, fishes, humans, cardiovascular diseases, atrial fibrillation, fatty acids, omega-3, treatment outcome, risk factors, dietary supplements, aged, female, male
6 autores
- Bariş Gencer🇨🇭University of Bern; University Hospital of Geneva
- Luc Djoussé🇺🇸Brigham and Women's Hospital
- Omar T. Al-Ramady🇺🇸Brigham and Women's Hospital
- Nancy R. Cook🇺🇸Brigham and Women's Hospital; Harvard University
- JoAnn E. Manson🇺🇸Brigham and Women's Hospital; Harvard University
- Christine M. Albert🇺🇸 · autor de correspondenciaCedars-Sinai Medical Center; Cedars-Sinai Smidt Heart Institute
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Some, but not all, large-scale randomized controlled trials (RCTs) investigating the effects of marine ɷ-3 fatty acids supplementation on cardiovascular outcomes have reported increased risks of atrial fibrillation (AF). The potential reasons for disparate findings may be dose-related.
Methods
The MEDLINE and Embase databases were searched for articles and abstracts published between January 1, 2012, and December 31, 2020, in addition to a meta-analysis of large cardiovascular RCTs published in 2019. RCTs of cardiovascular outcomes of marine ɷ-3 fatty acids that reported results for AF, either as a prespecified outcome, an adverse event, or a cause for hospitalization, with a minimum sample size of 500 patients and a median follow-up of at least 1 year were included. RCTs specifically examining shorter-term effects of ɷ-3 fatty acids on recurrent AF in patients with established AF or postoperative AF were not included. The hazard ratio (HR) for the reported AF outcomes within each trial was meta-analyzed using random effects model with Knapp-Hartung adjustment and evaluated a dose-response relationship with a meta-regression model.
Results
Of 4049 screened records, 7 studies were included in the meta-analysis. Of those, 5 were already detected in a previous meta-analysis of cardiovascular RCTs. Among the 81 210 patients from 7 trials, 58 939 (72.6%) were enrolled in trials testing ≤1 g/d and 22 271 (27.4%) in trials testing >1 g/d of ɷ-3 fatty acids. The mean age was 65 years, and 31 842 (39%) were female. The weighted average follow-up was 4.9 years. In meta-analysis, the use of marine ɷ-3 fatty acid supplements was associated with an increased risk of AF (n=2905; HR, 1.25 [95% CI, 1.07-1.46]; P=0.013). In analyses stratified by dose, the HR was greater in the trials testing >1 g/d (HR, 1.49 [95% CI, 1.04-2.15]; P=0.042) compared with those testing ≤1 g/d (HR, 1.12 [95% CI, 1.03-1.22]; P=0.024; P for interaction P=0.001).
Conclusions
In RCTs examining cardiovascular outcomes, marine ɷ-3 supplementation was associated with an increased risk of AF. The risk appeared to be greater in trials testing >1 g/d.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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