Tags

Type your tag names separated by a space and hit enter

Omega-3 dietary supplements and the risk of cardiovascular events: a systematic review.
Clin Cardiol 2009; 32(7):365-72CC

Abstract

BACKGROUND

Epidemiologic data suggest that omega-3 fatty acids derived from fish oil reduce cardiovascular disease. The clinical benefit of dietary fish oil supplementation in preventing cardiovascular events in both high and low risk patients is unclear.

OBJECTIVE

To assess whether dietary supplements of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) decrease cardiovascular events across a spectrum of patients.

DATA SOURCES

MEDLINE, Embase, the Cochrane Database of Systematic Reviews, and citation review of relevant primary and review articles.

STUDY SELECTION

Prospective, randomized, placebo-controlled clinical trials that evaluated clinical cardiovascular end points (cardiovascular death, sudden death, and nonfatal cardiovascular events) and all-cause mortality in patients randomized to EPA/DHA or placebo. We only included studies that used dietary supplements of EPA/DHA which were administered for at least 1 year.

DATA EXTRACTION

Data were abstracted on study design, study size, type and dose of omega-3 supplement, cardiovascular events, all-cause mortality, and duration of follow-up. Studies were grouped according to the risk of cardiovascular events (high risk and moderate risk). Meta-analytic techniques were used to analyze the data.

DATA SYNTHESIS

We identified 11 studies that included a total of 39 044 patients. The studies included patients after recent myocardial infarction, those with an implanted cardioverter defibrillator, and patients with heart failure, peripheral vascular disease, and hypercholesterolemia. The average dose of EPA/DHA was 1.8 +/- 1.2 g/day and the mean duration of follow-up was 2.2 +/- 1.2 years. Dietary supplementation with omega-3 fatty acids significantly reduced the risk of cardiovascular deaths (odds ratio [OR]: 0.87, 95% confidence interval [CI]: 0.79-0.95, p = 0.002), sudden cardiac death (OR: 0.87, 95% CI: 0.76-0.99, p = 0.04), all-cause mortality (OR: 0.92, 95% CI: 0.85-0.99, p = 0.02), and nonfatal cardiovascular events (OR: 0.92, 95% CI: 0.85-0.99, p = 0.02). The mortality benefit was largely due to the studies which enrolled high risk patients, while the reduction in nonfatal cardiovascular events was noted in the moderate risk patients (secondary prevention only). Meta-regression failed to demonstrate a relationship between the daily dose of omega-3 fatty acid and clinical outcome.

CONCLUSIONS

Dietary supplementation with omega-3 fatty acids should be considered in the secondary prevention of cardiovascular events.

Authors+Show Affiliations

Division of Pulmonary and Critical Care Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA. paul.marik@jefferson.eduNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

19609891

Citation

Marik, Paul E., and Joseph Varon. "Omega-3 Dietary Supplements and the Risk of Cardiovascular Events: a Systematic Review." Clinical Cardiology, vol. 32, no. 7, 2009, pp. 365-72.
Marik PE, Varon J. Omega-3 dietary supplements and the risk of cardiovascular events: a systematic review. Clin Cardiol. 2009;32(7):365-72.
Marik, P. E., & Varon, J. (2009). Omega-3 dietary supplements and the risk of cardiovascular events: a systematic review. Clinical Cardiology, 32(7), pp. 365-72. doi:10.1002/clc.20604.
Marik PE, Varon J. Omega-3 Dietary Supplements and the Risk of Cardiovascular Events: a Systematic Review. Clin Cardiol. 2009;32(7):365-72. PubMed PMID: 19609891.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Omega-3 dietary supplements and the risk of cardiovascular events: a systematic review. AU - Marik,Paul E, AU - Varon,Joseph, PY - 2009/7/18/entrez PY - 2009/7/18/pubmed PY - 2010/2/23/medline SP - 365 EP - 72 JF - Clinical cardiology JO - Clin Cardiol VL - 32 IS - 7 N2 - BACKGROUND: Epidemiologic data suggest that omega-3 fatty acids derived from fish oil reduce cardiovascular disease. The clinical benefit of dietary fish oil supplementation in preventing cardiovascular events in both high and low risk patients is unclear. OBJECTIVE: To assess whether dietary supplements of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) decrease cardiovascular events across a spectrum of patients. DATA SOURCES: MEDLINE, Embase, the Cochrane Database of Systematic Reviews, and citation review of relevant primary and review articles. STUDY SELECTION: Prospective, randomized, placebo-controlled clinical trials that evaluated clinical cardiovascular end points (cardiovascular death, sudden death, and nonfatal cardiovascular events) and all-cause mortality in patients randomized to EPA/DHA or placebo. We only included studies that used dietary supplements of EPA/DHA which were administered for at least 1 year. DATA EXTRACTION: Data were abstracted on study design, study size, type and dose of omega-3 supplement, cardiovascular events, all-cause mortality, and duration of follow-up. Studies were grouped according to the risk of cardiovascular events (high risk and moderate risk). Meta-analytic techniques were used to analyze the data. DATA SYNTHESIS: We identified 11 studies that included a total of 39 044 patients. The studies included patients after recent myocardial infarction, those with an implanted cardioverter defibrillator, and patients with heart failure, peripheral vascular disease, and hypercholesterolemia. The average dose of EPA/DHA was 1.8 +/- 1.2 g/day and the mean duration of follow-up was 2.2 +/- 1.2 years. Dietary supplementation with omega-3 fatty acids significantly reduced the risk of cardiovascular deaths (odds ratio [OR]: 0.87, 95% confidence interval [CI]: 0.79-0.95, p = 0.002), sudden cardiac death (OR: 0.87, 95% CI: 0.76-0.99, p = 0.04), all-cause mortality (OR: 0.92, 95% CI: 0.85-0.99, p = 0.02), and nonfatal cardiovascular events (OR: 0.92, 95% CI: 0.85-0.99, p = 0.02). The mortality benefit was largely due to the studies which enrolled high risk patients, while the reduction in nonfatal cardiovascular events was noted in the moderate risk patients (secondary prevention only). Meta-regression failed to demonstrate a relationship between the daily dose of omega-3 fatty acid and clinical outcome. CONCLUSIONS: Dietary supplementation with omega-3 fatty acids should be considered in the secondary prevention of cardiovascular events. SN - 1932-8737 UR - https://www.unboundmedicine.com/medline/citation/19609891/Omega_3_dietary_supplements_and_the_risk_of_cardiovascular_events:_a_systematic_review_ L2 - https://doi.org/10.1002/clc.20604 DB - PRIME DP - Unbound Medicine ER -