Dose-related meta-analysis for Omega-3 fatty acids supplementation on major adverse cardiovascular events.
Cardiovascular
Meta-analysis
Omega-3
Randomized controlled trials
Supplements
Journal
Clinical nutrition (Edinburgh, Scotland)
ISSN: 1532-1983
Titre abrégé: Clin Nutr
Pays: England
ID NLM: 8309603
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
07
06
2021
revised:
16
12
2021
accepted:
28
02
2022
pubmed:
16
3
2022
medline:
6
4
2022
entrez:
15
3
2022
Statut:
ppublish
Résumé
Omega-3 supplements are widely used for cardiovascular (CV) protection. We performed an updated meta-analysis for omega-3 and CV outcomes. Random-effects meta-analysis including double-blind RCTs with duration ≥1 year, evaluating omega-3 supplements in 4 a priori defined categories (<1, 1, 2, ≥3 of 1g capsules/day) on all-cause mortality, cardiac death, myocardial infarction and stroke, reporting the relative risk (RR) as the measure of interest. Complementary approaches were Trial Sequential Analysis (TSA) and sensitivity analyses for triglycerides, prevention setting, intention-to-treat analysis, eicosapentaenoic acid (EPA), sample size, statin use and study duration. Nineteen randomized controlled trials (RCTs) with 97,709 participants were included. Omega-3 supplements were not statistically significantly associated with reduced all-cause mortality, cardiac death, MI, or stroke, with the exception of reduced cardiac mortality only for the equivalent dose of 2 capsules/day (RR 0.55, 95%CI 0.33, 0.90, p = 0.0169, I Compared to the robust evidence for low doses, higher doses and particularly for the unique type of omega-3 icosapent ethyl ester should be further addressed.
Sections du résumé
BACKGROUND & AIMS
Omega-3 supplements are widely used for cardiovascular (CV) protection. We performed an updated meta-analysis for omega-3 and CV outcomes.
METHODS
Random-effects meta-analysis including double-blind RCTs with duration ≥1 year, evaluating omega-3 supplements in 4 a priori defined categories (<1, 1, 2, ≥3 of 1g capsules/day) on all-cause mortality, cardiac death, myocardial infarction and stroke, reporting the relative risk (RR) as the measure of interest. Complementary approaches were Trial Sequential Analysis (TSA) and sensitivity analyses for triglycerides, prevention setting, intention-to-treat analysis, eicosapentaenoic acid (EPA), sample size, statin use and study duration.
RESULTS
Nineteen randomized controlled trials (RCTs) with 97,709 participants were included. Omega-3 supplements were not statistically significantly associated with reduced all-cause mortality, cardiac death, MI, or stroke, with the exception of reduced cardiac mortality only for the equivalent dose of 2 capsules/day (RR 0.55, 95%CI 0.33, 0.90, p = 0.0169, I
CONCLUSION
Compared to the robust evidence for low doses, higher doses and particularly for the unique type of omega-3 icosapent ethyl ester should be further addressed.
Identifiants
pubmed: 35290840
pii: S0261-5614(22)00073-5
doi: 10.1016/j.clnu.2022.02.022
pii:
doi:
Substances chimiques
Fatty Acids, Omega-3
0
Triglycerides
0
Types de publication
Journal Article
Meta-Analysis
Langues
eng
Sous-ensembles de citation
IM
Pagination
923-930Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Déclaration de conflit d'intérêts
Conflict of interest ER has received speaker honoraria and consulting fees for clinical trials unelated to this work (Novartis, Sanofi, NovoNordisk, Pfizer, AstraZeneca/BMS, Eli Lilly, MSD/Vianex, Boehringer Ing, Amgen, GSK, Plus Pharmaceuticals, WinMedica, Servier). NK has received support for attending meetings unelated to this work (Bayer-Novagem, Pfizer, Boehringer-Ingelheim). IP is implicated in clinical studies using omega-3 intervention for neurodegenerative diseases unrelated to this work (PALUPA Medical Ltd). The rest of the coauthors declare no competing interests.