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The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis.

Abstract

BACKGROUND

Individuals with peripheral arterial disease are at higher risk for cardiovascular events than the general population. While supplementation with omega-3 polyunsaturated fatty acids (PUFA) has been shown to improve vascular function, it remains unclear if supplementation decreases serious clinical outcomes. We conducted a systematic review and meta-analysis to determine whether omega-3 PUFA supplementation reduces the incidence of cardiovascular events and complications in adults with peripheral arterial disease.

METHODS

We searched five electronic databases (MEDLINE, EMBASE, CENTRAL, Scopus and the International Clinical Trials Registry Platform) from inception to 6 December 2013 to identify randomized trials of omega-3 PUFA supplementation (from fish or plant oils) that lasted ≥12 weeks in adults with peripheral arterial disease. No language filters were applied. Data on trial design, population characteristics, and health outcomes were extracted. The primary outcome was major adverse cardiac events; secondary outcomes included myocardial infarction, cardiovascular death, stroke, angina, amputation, revascularization procedures, maximum and pain-free walking distance, adverse effects of the intervention, and quality of life. Trial quality was assessed using the Cochrane Risk of Bias tool.

RESULTS

Of 741 citations reviewed, we included five trials enrolling 396 individuals. All included trials were of unclear or high risk of bias. There was no evidence of a protective association of omega-3 PUFA supplementation against major adverse cardiac events (pooled risk ratio 0.73, 95% CI 0.22 to 2.41, I2 75%, 2 trials, 288 individuals) or other serious clinical outcomes. Adverse events and compliance were poorly reported.

CONCLUSIONS

Our results showed that insufficient evidence exists to suggest a beneficial effect of omega-3 PUFA supplementation in adults with peripheral arterial disease with regard to cardiovascular events and other serious clinical outcomes.

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  • Authors+Show Affiliations

    , , , , , ,

    Department of Physiology, University of Manitoba, Winnipeg, Canada. ctaylor@sbrc.ca.

    Source

    BMC cardiovascular disorders 14: 2014 May 31 pg 70

    MeSH

    Cerebrovascular Disorders
    Chi-Square Distribution
    Dietary Supplements
    Evidence-Based Medicine
    Fatty Acids, Omega-3
    Heart Diseases
    Humans
    Incidence
    Odds Ratio
    Peripheral Arterial Disease
    Protective Factors
    Risk Factors
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    24885361

    Citation

    Enns, Jennifer E., et al. "The Impact of Omega-3 Polyunsaturated Fatty Acid Supplementation On the Incidence of Cardiovascular Events and Complications in Peripheral Arterial Disease: a Systematic Review and Meta-analysis." BMC Cardiovascular Disorders, vol. 14, 2014, p. 70.
    Enns JE, Yeganeh A, Zarychanski R, et al. The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2014;14:70.
    Enns, J. E., Yeganeh, A., Zarychanski, R., Abou-Setta, A. M., Friesen, C., Zahradka, P., & Taylor, C. G. (2014). The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis. BMC Cardiovascular Disorders, 14, p. 70. doi:10.1186/1471-2261-14-70.
    Enns JE, et al. The Impact of Omega-3 Polyunsaturated Fatty Acid Supplementation On the Incidence of Cardiovascular Events and Complications in Peripheral Arterial Disease: a Systematic Review and Meta-analysis. BMC Cardiovasc Disord. 2014 May 31;14:70. PubMed PMID: 24885361.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The impact of omega-3 polyunsaturated fatty acid supplementation on the incidence of cardiovascular events and complications in peripheral arterial disease: a systematic review and meta-analysis. AU - Enns,Jennifer E, AU - Yeganeh,Azadeh, AU - Zarychanski,Ryan, AU - Abou-Setta,Ahmed M, AU - Friesen,Carol, AU - Zahradka,Peter, AU - Taylor,Carla G, Y1 - 2014/05/31/ PY - 2014/03/17/received PY - 2014/05/28/accepted PY - 2014/6/3/entrez PY - 2014/6/3/pubmed PY - 2015/1/21/medline SP - 70 EP - 70 JF - BMC cardiovascular disorders JO - BMC Cardiovasc Disord VL - 14 N2 - BACKGROUND: Individuals with peripheral arterial disease are at higher risk for cardiovascular events than the general population. While supplementation with omega-3 polyunsaturated fatty acids (PUFA) has been shown to improve vascular function, it remains unclear if supplementation decreases serious clinical outcomes. We conducted a systematic review and meta-analysis to determine whether omega-3 PUFA supplementation reduces the incidence of cardiovascular events and complications in adults with peripheral arterial disease. METHODS: We searched five electronic databases (MEDLINE, EMBASE, CENTRAL, Scopus and the International Clinical Trials Registry Platform) from inception to 6 December 2013 to identify randomized trials of omega-3 PUFA supplementation (from fish or plant oils) that lasted ≥12 weeks in adults with peripheral arterial disease. No language filters were applied. Data on trial design, population characteristics, and health outcomes were extracted. The primary outcome was major adverse cardiac events; secondary outcomes included myocardial infarction, cardiovascular death, stroke, angina, amputation, revascularization procedures, maximum and pain-free walking distance, adverse effects of the intervention, and quality of life. Trial quality was assessed using the Cochrane Risk of Bias tool. RESULTS: Of 741 citations reviewed, we included five trials enrolling 396 individuals. All included trials were of unclear or high risk of bias. There was no evidence of a protective association of omega-3 PUFA supplementation against major adverse cardiac events (pooled risk ratio 0.73, 95% CI 0.22 to 2.41, I2 75%, 2 trials, 288 individuals) or other serious clinical outcomes. Adverse events and compliance were poorly reported. CONCLUSIONS: Our results showed that insufficient evidence exists to suggest a beneficial effect of omega-3 PUFA supplementation in adults with peripheral arterial disease with regard to cardiovascular events and other serious clinical outcomes. SN - 1471-2261 UR - https://www.unboundmedicine.com/medline/citation/24885361/The_impact_of_omega_3_polyunsaturated_fatty_acid_supplementation_on_the_incidence_of_cardiovascular_events_and_complications_in_peripheral_arterial_disease:_a_systematic_review_and_meta_analysis_ L2 - https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/1471-2261-14-70 DB - PRIME DP - Unbound Medicine ER -