Endogenous levels of omega-3 fatty acids not associated with increased AF risk
Omega-3 Fatty Acid Biomarkers and Incident Atrial FibrillationLiterature - Qian F, Tintle N, Jensen PN, et al - J Am Coll Cardiol. 2023 Jul 25;82(4):336-349. doi: 10.1016/j.jacc.2023.05.024
Introduction and methods
The relationship between omega-3 polyunsaturated fatty acid supplementation and the occurrence of AF remains controversial. Previous studies have shown no effect on the risk of postsurgical AF , increased risk of AF hospitalization in patients with pre-existing CVD or at high CVD risk [2-4], or neither benefit nor harm regarding AF incidence among individuals with no history of CVD . The few prospective cohort studies from Europe and the USA that examined the endogenous omega-3 fatty acid status in relation to incident AF indicated inverse associations, with DHA being most consistently related to lower AF risk [6-10].
Aim of the study
The authors evaluated the relationship between circulating and tissue levels of eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) and incident AF across 17 international prospective studies.
In this meta-analysis, participant-level data on baseline measurements of blood and/or adipose tissue omega-3 fatty acid levels and AF outcomes were pooled from a global consortium of 17 prospective cohort studies from 21 nations (in North America, Europe, Asia, and Africa) (54,799 patients in total). During a median follow-up time of 13.3 years (range: 0.9–29.1), 7720 incident cases of AF were observed.
- I n multivariable-adjusted analyses, EPA levels were not associated with incident AF. The HR per interquintile range (i.e., difference between 90th and 10th percentiles) was 1.00 (95%CI: 0.95–1.05), with moderate heterogeneity (I²=52.2%).
- In contrast, the other omega-3 fatty acids were associated with a lower incidence of AF. The HR per interquintile range was 0.89 (95%CI: 0.83–0.95; I²=0.0%) for DPA, 0.90 (95%CI: 0.85–0.96; I²=47.5%) for DHA, and 0.93 (95%CI: 0.87–0.99; I²=60.7%) for EPA+DHA.
- Pooled categorical analyses comparing extreme quintiles (i.e., first and fifth groups categorized by quintile values in each cohort) showed similar associations.
- Subgroup analyses showed that for each omega-3 fatty acid, the association with incident AF did not differ significantly among patients with increased CVD risk, nor in subgroups stratified by age, sex, or global region (all P for heterogeneity>0.05).
This meta-analysis of 17 prospective cohort studies on circulating and adipose tissue levels of omega-3 fatty acids showed there was no association between EPA and incident AF, whereas higher levels of DPA, DHA, and EPA+DHA were each associated with a lower risk of AF. The authors believe their “data suggest the safety of habitual dietary intakes of omega-3 fatty acids with respect to AF risk.”