Levels of omega-3 fatty acids in diet not linked to elevated risk for atrial fibrillation
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Key takeaways:
- Levels of omega-3 fatty acids were not related to risk for atrial fibrillation.
- Most participants were not taking omega-3 fatty acid supplements, which have been linked to atrial fibrillation risk.
Levels of omega-3 fatty acids, primarily from diet, were not related to risk for incident atrial fibrillation, according to a meta-analysis published in the Journal of the American College of Cardiology.
The findings contrast with results of trials of omega-3 fatty acid supplementation, which found omega-3 fatty acid supplementation was associated with elevated risk for AF.
Frank Qian, MD, an internal medicine resident physician at Beth Israel Deaconess Medical Center and a clinical fellow in medicine at Harvard Medical School, and colleagues conducted a meta-analysis of 54,799 participants (mean age, 63 years; 47% women) from 17 prospective cohort studies who had data on baseline levels of omega-3 fatty acids — eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) — in blood or adipose tissue and on incident AF during follow-up. Most participants were not taking omega-3 fatty acid supplements, meaning their omega-3 fatty acid levels were primarily determined by their diets.
After a median of 13.3 years of follow-up, there were 7,720 cases of incident AF, according to the researchers.
In multivariate analyses, levels of EPA were not associated with incident AF (HR per interquintile range = 1; 95% CI, 0.95-1.05), nor were levels of DPA (HR per interquintile range = 0.89; 95% CI, 0.83-0.95), DHA (HR per interquintile range = 0.9; 95% CI, 0.85-0.96) or EPA plus DHA (HR per interquintile range = 0.93; 95% CI, 0.87-0.99).
The results were similar in patients at elevated CV risk and did not vary by age, sex or region.
“There are several potential reasons why the results of the present study may differ from recent omega-3 randomized controlled trials,” Qian and colleagues wrote. “First, the majority of the participants included in our study were community-dwelling individuals who were free of CVD or at relatively low CV risk. In contrast ... [the randomized trials] typically enrolled individuals with baseline CVD or were at elevated CV risk. It is conceivable that the effects of omega-3 fatty acids on atrial arrhythmias may differ in those with existing CVD vs. without. ... Second, the prevalence of omega-3 fatty acid supplement use in our cohorts was very low, meaning that biomarker levels of these fatty acids largely reflect habitual dietary intake. ... Randomized controlled trials of generally short-term, high-dose encapsulated omega-3 agents are unlikely to mimic the long-term impact of habitual dietary omega-3 fatty acid intake on AF risk.”
In a related editorial, Christie M. Ballantyne, MD, FACC, FACP, FAHA, FNLA, chief of the section of cardiovascular research and professor of medicine at Baylor College of Medicine, and Xiaoming Jia, MD, interventional cardiologist and assistant professor of medicine at Baylor College of Medicine, wrote that “based on present evidence, moderate dietary intake of fish and seafood is unlikely to achieve sufficiently high levels of omega-3 fatty acids in blood or tissue that would result in increased AF risk as observed in clinical trials of fish oil supplements and high-dose prescriptions of EPA and EPA + DHA. Therefore, fish should continue to be an important part of the menu of a heart-healthy diet.”
Reference:
- Ballantyne CM, et al. J Am Coll Cardiol. 2023;doi:10.1016/j.jacc.2023.05.026.
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