All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network Meta-Analysis from 55 Randomized Controlled Trials.
Aged
Cardiovascular Diseases
/ mortality
Cause of Death
Dietary Supplements
Fatty Acids, Omega-3
/ administration & dosage
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ therapeutic use
Male
Middle Aged
Mortality
Network Meta-Analysis
Primary Prevention
Randomized Controlled Trials as Topic
Secondary Prevention
cardiovascular disease
mortality
network meta-analysis
omega-3
statin
Journal
Nutrients
ISSN: 2072-6643
Titre abrégé: Nutrients
Pays: Switzerland
ID NLM: 101521595
Informations de publication
Date de publication:
20 Oct 2020
20 Oct 2020
Historique:
received:
24
09
2020
revised:
17
10
2020
accepted:
19
10
2020
entrez:
23
10
2020
pubmed:
24
10
2020
medline:
1
4
2021
Statut:
epublish
Résumé
Statins and omega-3 supplementation have shown potential benefits in preventing cardiovascular disease (CVD), but their comparative effects on mortality outcomes, in addition to primary and secondary prevention and mixed population, have not been investigated. This study aimed to examine the effect of statins and omega-3 supplementation and indirectly compare the effects of statin use and omega-3 fatty acids on all-cause mortality and CVD death. We included randomized controlled trials (RCTs) from meta-analyses published until December 2019. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated to indirectly compare the effect of statin use versus omega-3 supplementation in a frequentist network meta-analysis. In total, 55 RCTs were included in the final analysis. Compared with placebo, statins were significantly associated with a decreased the risk of all-cause mortality (RR = 0.90, 95% CI = 0.86-0.94) and CVD death (RR = 0.86, 95% CI = 0.80-0.92), while omega-3 supplementation showed a borderline effect on all-cause mortality (RR = 0.97, 95% CI = 0.94-1.01) but were significantly associated with a reduced risk of CVD death (RR = 0.92, 95% CI = 0.87-0.98) in the meta-analysis. The network meta-analysis found that all-cause mortality was significantly different between statin use and omega-3 supplementation for overall population (RR = 0.91, 95% CI = 0.85-0.98), but borderline for primary prevention and mixed population and nonsignificant for secondary prevention. Furthermore, there were borderline differences between statin use and omega-3 supplementation in CVD death in the total population (RR = 0.92, 95% CI = 0.82-1.04) and primary prevention (RR = 0.85, 95% CI = 0.68-1.05), but nonsignificant differences in secondary prevention (RR = 0.97, 95% CI = 0.66-1.43) and mixed population (RR = 0.92, 95% CI = 0.75-1.14). To summarize, statin use might be associated with a lower risk of all-cause mortality than omega-3 supplementation. Future direct comparisons between statin use and omega-3 supplementation are required to confirm the findings.
Identifiants
pubmed: 33092130
pii: nu12103203
doi: 10.3390/nu12103203
pmc: PMC7590109
pii:
doi:
Substances chimiques
Fatty Acids, Omega-3
0
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Types de publication
Comparative Study
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Korean Society of Lipid and Atherosclerosis
ID : NA
Organisme : National Cancer Center, Korea
ID : 1910330
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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