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Omega-3 fatty acids unsuccessful in reducing CHD, vascular events
Omega-3 fatty acids did not reduce nor increase the risk for fatal or nonfatal CHD or major vascular events in patients who are high risk, according to a meta-analysis published in JAMA Cardiology.
Theingi Aung, MBBS, FRCP, of the Nuffield Department of Population Health at the University of Oxford in England, and colleagues analyzed data from 77,917 patients (mean age, 64 years; 61% men) from 10 clinical trials.
The meta-analysis included randomized clinical trials of marine-derived very-long-chain omega-3 fatty acid supplements compared with placebo or open-label control. Trials included at least 500 patients with a treatment period of at least 1 year.
The prespecified endpoints of interest included death caused by CHD, nonfatal MI, coronary or noncoronary arterial revascularization events, major vascular events, all-cause mortality and hemorrhagic, ischemic and unclassified stroke.
Treatment was conducted for a mean of 4.4 years. During the trials, 15.4% of patients had major vascular events, 2.9% had nonfatal MI and 3.5% had CHD-related deaths.
Omega-3 fatty acids did not affect the rates of any CHD event (RR = 0.96; 99% CI, 0.9-1.01). This was also seen in subgroups of CHD events, including nonfatal MI (RR = 0.97; 99% CI, 0.87-1.08) and CHD death (RR = 0.93; 99% CI, 0.83-1.03).
Rates of major vascular events were not affected in patients who received omega-3 fatty acids (RR = 0.97; 95% CI, 0.93-1.01).
After adjusting for multiple testing, omega-3 fatty acids were not associated with the rate of major vascular events in prespecified subgroups, including history of diabetes, history of CHD, lipid levels greater than a cutoff level and prior use of statin therapy.
The association between omega-3 fatty acids and CHD death, nonfatal MI or overall CHD was not seen in trials with masked or open-label designs. Omega-3 fatty acids were also not associated with all-cause mortality (RR = 0.96; 95% CI, 0.92-1.01).
“The results of the present meta-analysis provide no support for the recommendations to use approximately 1 [gram per day] of omega-3 [fatty acids] in individuals with a history of CHD for the prevention of fatal CHD, nonfatal MI or any other vascular events,” Aung and colleagues wrote. “The results of the ongoing trials are needed to assess if higher doses of omega-3 [fatty acids] (3-4 g/d) may have significant effects on risk of major vascular events.” – by Darlene Dobkowski
Disclosures: Aung reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.