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Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis

EClinicalMedicine, 2021-08, Vol.38, p.100997-100997, Article 100997 [Peer Reviewed Journal]

2021 The Author(s) ;2021 The Author(s). ;2021 The Author(s) 2021 ;ISSN: 2589-5370 ;EISSN: 2589-5370 ;DOI: 10.1016/j.eclinm.2021.100997 ;PMID: 34505026

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  • Title:
    Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis
  • Author: Khan, Safi U. ; Lone, Ahmad N. ; Khan, Muhammad Shahzeb ; Virani, Salim S. ; Blumenthal, Roger S. ; Nasir, Khurram ; Miller, Michael ; Michos, Erin D. ; Ballantyne, Christie M. ; Boden, William E. ; Bhatt, Deepak L.
  • Subjects: Docosahexaenoic acid ; Eicosapentaenoic acid ; Meta-analysis ; Omega-3 fatty acid ; Research Paper
  • Is Part Of: EClinicalMedicine, 2021-08, Vol.38, p.100997-100997, Article 100997
  • Description: 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. 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). 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]). Omega-3 FAs reduced cardiovascular mortality and improved cardiovascular outcomes. The cardiovascular risk reduction was more prominent with EPA monotherapy than with EPA+DHA. None.
  • Publisher: England: Elsevier Ltd
  • Language: English
  • Identifier: ISSN: 2589-5370
    EISSN: 2589-5370
    DOI: 10.1016/j.eclinm.2021.100997
    PMID: 34505026
  • Source: TestCollectionTL3OpenAccess
    PubMed Central
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