Physicians' Academy for Cardiovascular Education

Omega-3 fatty acid supplements do not reduce CV risk

Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks Meta-analysis of 10 Trials Involving 77917 Individuals

Aung T, Halsey J, Kromhout D, et al - JAMA Cardiol 2018; published online ahead of print

Background

Data on the prevention of coronary heart disease (CHD) and major vascular events related to omega-3 fatty acids (FA) are conflicting [1-4]. Several guidelines indicated that it is debatable whether omega-3 FAs may exert a protective effect and more evidence is needed to justify their prescription [5,6]. In contrast, the American Heart Association recommended that the intake of omega-3 FAs for CHD prevention is likely justified in individuals with prior CHD and those with HFrEF [7]. In this meta-analysis, the association between the consumption of omega-3 FA supplements and the risk of fatal CHD, non-fatal MI, stroke, major vascular events and all-cause mortality, and major vascular events in subgroups was evaluated.

Eligible for the meta-analysis were randomized clinical trials of marine-derived very-long-chain omega-3 FA supplements compared with placebo, or open-label control studies, with at least 500 participants and a scheduled duration of treatment of at least 1 year. Marine-derived omega-3 FAs include eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA) found in fish and other seafood; no minimum daily dose of EPA or DHA was specified.

The pre-specified endpoints included non-fatal myocardial infarction (MI), death caused by CHD, stroke, coronary or non-coronary arterial revascularization events, major vascular events (a composite of the first occurrence of non-fatal MI or death caused by CHD, non-fatal or fatal stroke; or any revascularization procedure), and all-cause mortality.

The PRISMA guidelines [8] were followed for the conduct of meta-analysis of randomized trials. Pooled tabular data were obtained from 9 trials, and the detailed published results of 1 more study were used. The 10 studies together included 77,917 participants.

Main results

Conclusion

A large meta-analysis showed that omega-3 FA supplementation is not associated with a reduction in fatal and non-fatal CHD and other major vascular events. These data do not support the recommendation to use of ~1 g/d of omega-3-FA supplements for the prevention of CV events. It will be interesting to see whether higher doses of omega-3 FA (3-4 g/d) may have significant effects on risk of major vascular events.

References

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Find this article online at JAMA Cardiol 2018