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Omega-3 supplementation failed to reduce incident AF in patients with chronic HF
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Supplementation with omega-3 polyunsaturated fatty acids did not reduce incident atrial fibrillation for patients with chronic HF in a new analysis of the GISSI-HF trial.
However, researchers identified a relationship between lower prevalence of AF and higher levels of n-3 polyunsaturated fatty acids (PUFAs).
Previous research has indicated that n-3 PUFAs may slow the development of AF, but the effect of supplementation has not been studied in patients with HF, according to the researchers.
“To the best of our knowledge, this clinical study is the first to investigate the effect of n-3 PUFAs on AF in patients with chronic HF,” Aneta Aleksova, MD, MSc, of the University of Trieste, Italy, and colleagues wrote in the study.
The post-hoc analysis focused on 5,835 patients with chronic HF in the 6,975-patient GISSI-HF trial who did not have AF at baseline (mean age, 66 years; mean LV ejection fraction, 32.6%). About half were assigned 1 g/day of n-3 PUFAs and the rest were assigned placebo; all patients also received recommended therapy for HF. Median follow-up was 3.9 years.
Incident AF was defined as the presence of AF on ECGs performed on each patient at each visit, AF as a cause of worsening HF or hospital admission during the study period, or an event during hospitalization.
Results showed no difference between the groups in incident AF during the study period (n-3 PUFA group, 15.2%; placebo group, 14%; HR=1.1; 95% CI, 0.96-1.25). There was also no difference when adjusting for age, LVEF, HF etiology, NYHA functional class, diabetes, cholesterol levels, renal function, history of paroxysmal AF or dietary fish consumption.
After subtracting those with a history of AF and those with pacemaker rhythm at baseline ECG from the analysis, the n-3 PUFA group had a greater incidence of AF during the study period compared with the placebo group (11% vs. 9%; HR=1.23; 95% CI, 1.02-1.48).
In a subgroup of 1,203 patients from the full set of 6,975 who had plasma levels of n-3 PUFAs measured, the prevalence of AF declined as levels of n-3 PUFAs increased. Patients in the lowest tertile of that subgroup (≤4.32 mol%) had a nearly twofold higher risk for AF than those in the highest tertile (>5.43 mol%; OR=1.84; 95% CI, 1.15-2.95), the researchers found.
Disclosure: The study was funded in part by, and some researchers report financial ties to, AstraZeneca, Pfizer and Sigma Tau Pharmaceuticals.
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