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Efficacy of omega-3 fatty acid supplements (eicosapentaenoic acid and docosahexaenoic acid) in the secondary prevention of cardiovascular disease: a meta-analysis of randomized, double-blind, placebo-controlled trials.
Arch Intern Med 2012; 172(9):686-94AI

Abstract

BACKGROUND

Although previous randomized, double-blind, placebo-controlled trials reported the efficacy of omega-3 fatty acid supplements in the secondary prevention of cardiovascular disease (CVD), the evidence remains inconclusive. Using a meta-analysis, we investigated the efficacy of eicosapentaenoic acid and docosahexaenoic acid in the secondary prevention of CVD.

METHODS

We searched PubMed, EMBASE, and the Cochrane Library in April 2011. Two of us independently reviewed and selected eligible randomized controlled trials.

RESULTS

Of 1007 articles retrieved, 14 randomized, double-blind, placebo-controlled trials (involving 20 485 patients with a history of CVD) were included in the final analyses. Supplementation with omega-3 fatty acids did not reduce the risk of overall cardiovascular events (relative risk, 0.99; 95% CI, 0.89-1.09), all-cause mortality, sudden cardiac death, myocardial infarction, congestive heart failure, or transient ischemic attack and stroke. There was a small reduction in cardiovascular death (relative risk, 0.91; 95% CI, 0.84-0.99), which disappeared when we excluded a study with major methodological problems. Furthermore, no significant preventive effect was observed in subgroup analyses by the following: country location, inland or coastal geographic area, history of CVD, concomitant medication use, type of placebo material in the trial, methodological quality of the trial, duration of treatment, dosage of eicosapentaenoic acid or docosahexaenoic acid, or use of fish oil supplementation only as treatment.

CONCLUSION

Our meta-analysis showed insufficient evidence of a secondary preventive effect of omega-3 fatty acid supplements against overall cardiovascular events among patients with a history of cardiovascular disease.

Authors+Show Affiliations

Center for Cancer Prevention and Detection, Ilsan, Republic of Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

22493407

Citation

Kwak, Sang Mi, et al. "Efficacy of Omega-3 Fatty Acid Supplements (eicosapentaenoic Acid and Docosahexaenoic Acid) in the Secondary Prevention of Cardiovascular Disease: a Meta-analysis of Randomized, Double-blind, Placebo-controlled Trials." Archives of Internal Medicine, vol. 172, no. 9, 2012, pp. 686-94.
Kwak SM, Myung SK, Lee YJ, et al. Efficacy of omega-3 fatty acid supplements (eicosapentaenoic acid and docosahexaenoic acid) in the secondary prevention of cardiovascular disease: a meta-analysis of randomized, double-blind, placebo-controlled trials. Arch Intern Med. 2012;172(9):686-94.
Kwak, S. M., Myung, S. K., Lee, Y. J., & Seo, H. G. (2012). Efficacy of omega-3 fatty acid supplements (eicosapentaenoic acid and docosahexaenoic acid) in the secondary prevention of cardiovascular disease: a meta-analysis of randomized, double-blind, placebo-controlled trials. Archives of Internal Medicine, 172(9), pp. 686-94. doi:10.1001/archinternmed.2012.262.
Kwak SM, et al. Efficacy of Omega-3 Fatty Acid Supplements (eicosapentaenoic Acid and Docosahexaenoic Acid) in the Secondary Prevention of Cardiovascular Disease: a Meta-analysis of Randomized, Double-blind, Placebo-controlled Trials. Arch Intern Med. 2012 May 14;172(9):686-94. PubMed PMID: 22493407.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of omega-3 fatty acid supplements (eicosapentaenoic acid and docosahexaenoic acid) in the secondary prevention of cardiovascular disease: a meta-analysis of randomized, double-blind, placebo-controlled trials. AU - Kwak,Sang Mi, AU - Myung,Seung-Kwon, AU - Lee,Young Jae, AU - Seo,Hong Gwan, AU - ,, PY - 2012/4/12/entrez PY - 2012/4/12/pubmed PY - 2012/9/22/medline SP - 686 EP - 94 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 172 IS - 9 N2 - BACKGROUND: Although previous randomized, double-blind, placebo-controlled trials reported the efficacy of omega-3 fatty acid supplements in the secondary prevention of cardiovascular disease (CVD), the evidence remains inconclusive. Using a meta-analysis, we investigated the efficacy of eicosapentaenoic acid and docosahexaenoic acid in the secondary prevention of CVD. METHODS: We searched PubMed, EMBASE, and the Cochrane Library in April 2011. Two of us independently reviewed and selected eligible randomized controlled trials. RESULTS: Of 1007 articles retrieved, 14 randomized, double-blind, placebo-controlled trials (involving 20 485 patients with a history of CVD) were included in the final analyses. Supplementation with omega-3 fatty acids did not reduce the risk of overall cardiovascular events (relative risk, 0.99; 95% CI, 0.89-1.09), all-cause mortality, sudden cardiac death, myocardial infarction, congestive heart failure, or transient ischemic attack and stroke. There was a small reduction in cardiovascular death (relative risk, 0.91; 95% CI, 0.84-0.99), which disappeared when we excluded a study with major methodological problems. Furthermore, no significant preventive effect was observed in subgroup analyses by the following: country location, inland or coastal geographic area, history of CVD, concomitant medication use, type of placebo material in the trial, methodological quality of the trial, duration of treatment, dosage of eicosapentaenoic acid or docosahexaenoic acid, or use of fish oil supplementation only as treatment. CONCLUSION: Our meta-analysis showed insufficient evidence of a secondary preventive effect of omega-3 fatty acid supplements against overall cardiovascular events among patients with a history of cardiovascular disease. SN - 1538-3679 UR - https://www.unboundmedicine.com/medline/citation/22493407/Efficacy_of_omega_3_fatty_acid_supplements__eicosapentaenoic_acid_and_docosahexaenoic_acid__in_the_secondary_prevention_of_cardiovascular_disease:_a_meta_analysis_of_randomized_double_blind_placebo_controlled_trials_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinternmed.2012.262 DB - PRIME DP - Unbound Medicine ER -