Omega-3 fatty acids reduce HF hospitalization in T2DM patients

Introduction and methods

Background

The VITAL-HF study, an ancillary study of the VITAL trial, – which included > 5000 black participants – demonstrated that marine omega-3 fatty acids reduced the number of recurrent HF hospitalizations [1]. Nevertheless data on the effects of omega-3 fatty acids on the incidence of HF in general terms and in patients with type 2 diabetes mellitus (T2DM) are limited and inconsistent. Also, the role of race/ethnicity in assessing the interaction of T2DM with omega-3 supplementation on first and recurrent HF hospitalization has not been evaluated before.

Aim of the study

Primary objective of the current analysis of the VITAL-HF study was to assess the effects of omega-3 supplementation on the incidence of first and recurrent HF hospitalization in patients with T2DM and in those without T2DM. As a secondary objective, researchers aimed to assess whether race modified the effect of omega-3 fatty acids on HF hospitalization.

Methods

The VITAL trial was a randomized, placebo-controlled trial investigating the effect of vitamin D and marine omega-3 fatty acids (a mixture of 460 mg EPA and 380 mg DHA) on the prevention of CVD and cancer. Median follow-up was 5.3 years (range: 0-6.1 years). In the VITAL-HF study, 25,835 participants without HF at baseline were included. The overall prevalence of T2DM was 14%. 71.3% of participants were white (non-Hispanic) and 20.2% were black.

Outcomes

Primary outcome in the current analysis of the VITAL-HF study was first HF hospitalization. Secondary outcome was recurrent HF hospitalization.

Main results

• First HF hospitalization occurred in 3.6% of people with T2DM who received omega-3 fatty acids and 5.2% of people with T2D who received placebo (HR 0.69, 95%CI:0.50-0.95); for people without T2DM, HR was 1.09 (95%CI: 0.88-1.34)(Pinteraction=0.019).
• With regard to effect modification by T2DM for recurrent HF hospitalization, the benefit of omega-3 fatty acids was more pronounced in people with T2DM (HR 0.53, 95%CI:0,41-0,69) than in those without T2DM (HR 1.07, 95%CI: 0,89-1,28)
• In the total population, supplementation with omega-3 fatty acids reduced the number of recurrent HF hospitalizations only in black people (HR 0.65, 95%CI:0.49-0.88), not in white. In patients with T2DM, reductions in recurrent HF hospitalizations with omega-3 fatty acids were seen in black participants (HR 0.46, 95%CI:0.30-0.70) as well as in white participants (HR 0.65, 95%CI:0.45-0.92).

Conclusion

References

Find this article online at JACC Heart Fail.