Impact of Different Doses of Omega-3 Fatty Acids on Cardiovascular Outcomes: a Pairwise and Network Meta-analysis
Abstract
Purpose of review Omega-3 fatty acid (O3FA) supplementation has shown conflicting evidence regarding its benefit in cardiovascular events. We performed a pairwise and network meta-analysis to elucidate the benefit of different doses of O3FA supplementation in cardiovascular prevention. Recent findings Fourteen studies were identified providing data on 125,763 patients. A prespecified cut-off value of 1 g per day for high-dose (HD) O3FA. The efficacy outcomes of interest were total death, cardiac death, sudden cardiac death, myocardial infarction, stroke, coronary revascularization, unstable angina, and major vascular events. Safety outcomes of interest were bleeding, gastrointestinal disturbances, and atrial fibrillation events. HD treatment was associated with a lower risk of cardiac death (IRR 0.79, 95% CI [0.65-0.96], p = 0.03 versus control), myocardial infarction (0.71 [0.62-0.82], p < 0.0001 versus control and 0.79 [0.67-0.92], p = 0.003 versus LD), coronary revascularization (0.74 [0.66-0.83], p < 0.0001 versus control and 0.74 [0.66-0.84], p < 0.0001 versus LD), unstable angina (0.73 [0.62-0.86], p = 0.0001 versus control and 0.74 [0.62-0.89], p = 0.002 versus LD), and major vascular events (0.78 [0.71-0.85], p < 0.0001 versus control and 0.79 [0.72-0.88], p < 0.0001 versus LD). HD treatment was associated with increased risk for bleeding events (1.49 [1.2-1.84], p = 0.0002 versus control and 1.63 [1.16-2.3], p = 0.005 versus LD) and increased atrial fibrillation even…
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Several cardiovascular outcomes trials of omega-3 fatty acid supplementation showed a potential increase in atrial fibrillation compared with placebo.
“Safety has been, however, questioned as several cardiovascular (CV) outcomes trials of O3FA supplementation showed a potential increase of AF, when compared with placebo.2”
From Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials (2021) · cites this paper as [2]
Even lower doses of omega-3 fatty acid supplementation have shown a potential signal for increased risk for atrial fibrillation.
“Even lower doses of O3FA supplementation has shown a potential signal for increased risk for AF,2,4,5”
From Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials (2021) · cites this paper as [2]
Regardless of the dose of omega-3 fatty acid supplementation implemented in the trials and potential-related benefits on cardiovascular outcomes, omega-3 fatty acid supplementation may increase the risk for atrial fibrillation.
“proposing that regardless of the dose of O3FA supplementation implemented in the trials and potential-related benefits on CV outcomes, O3FA supplementation may increase the risk for AF.”
From Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials (2021) · cites this paper as [2]
Omega-3 fatty acids have been previously shown to stabilize the cardiac membrane resulting in protective effects against arrhythmias, including ventricular arrhythmias.
“In fact, O3FA have been previously shown to stabilize the cardiac membrane resulting in protective effects against arrhythmias, including ventricular arrhythmias.2,8”
From Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials (2021) · cites this paper as [2]
Lower doses of omega-3 fatty acid supplementation have not improved cardiovascular outcomes.
“Moreover, lower doses of O3FA supplementation have not improved CV outcomes.2”
From Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials (2021) · cites this paper as [2]
Cites
RoB 2: a revised tool for assessing risk of bias in randomised trials
Sterne, J. A. C., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., Cates, C. J., Cheng, H.-Y., Corbett, M. S., Eldridge, S. M., et al. (2019) · BMJ · doi:10.1136/bmj.l4898 · Cited by 33,583 · see citing works
Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia
Bhatt, D. L., Steg, P. G., Miller, M., Brinton, E. A., Jacobson, T. A., Ketchum, S. B., Doyle, R. T., Juliano, R. A., Jiao, L., Granowitz, C., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1812792 · Cited by 3,317 · see citing works
Marine n−3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer
Manson, J. E., Cook, N. R., Lee, I.-M., Christen, W., Bassuk, S. S., Mora, S., Gibson, H., Albert, C. M., Gordon, D., Copeland, T., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1811403 · Cited by 979 · see citing works
Rauch, B., Schiele, R., Schneider, S., Diller, F., Victor, N., Gohlke, H., Gottwik, M., Steinbeck, G., Del Castillo, U., Sack, R., et al. (2010) · Circulation · doi:10.1161/circulationaha.110.948562 · Cited by 607 · see citing works
n–3 Fatty Acids in Patients with Multiple Cardiovascular Risk Factors
The Risk and Prevention Study Collaborative Group (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1205409 · Cited by 510 · see citing works
Galan, P., Kesse-Guyot, E., Czernichow, S., Briancon, S., Blacher, J., Hercberg, S., & for the SU.FOL.OM3 Collaborative Group (2010) · BMJ · doi:10.1136/bmj.c6273 · Cited by 457 · see citing works
Hu, Y., Hu, F. B., & Manson, J. E. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.119.013543 · Cited by 388 · see citing works
Nicholls, S. J., Lincoff, A. M., Bash, D., Ballantyne, C. M., Barter, P. J., Davidson, M. H., Kastelein, J. J. P., Koenig, W., McGuire, D. K., Mozaffarian, D., et al. (2018) · Clinical Cardiology · doi:10.1002/clc.23055 · Cited by 167 · see citing works
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Lombardi, M., Carbone, S., Del Buono, M. G., Chiabrando, J. G., Vescovo, G. M., Camilli, M., Montone, R. A., Vergallo, R., Abbate, A., Biondi-Zoccai, G., et al. (2021) · European Heart Journal - Cardiovascular Pharmacotherapy · doi:10.1093/ehjcvp/pvab008 · Cited by 68 · see citing works
Self-citationDinu, M., Sofi, F., Lotti, S., Colombini, B., Mattioli, A. V., Catapano, A. L., Casula, M., Baragetti, A., Wong, N. D., Steg, P. G., et al. (2024) · European Journal of Preventive Cardiology · doi:10.1093/eurjpc/zwae184 · Cited by 17 · see citing works
- Authors
- Lombardi, M., Chiabrando, J. G., Vescovo, G. M., Bressi, E., Del Buono, M. G., Carbone, S., Koenig, R. A., Van Tassell, B. W., Abbate, A., Biondi-Zoccai, G., & Dixon, D. L.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- Universidad de Buenos Aires (AR)
- University of Padua (IT)
- Virginia Commonwealth University (US)
- Corresponding author
- Dixon, Dave L.
- ORCID
- Venue
- Current Atherosclerosis Reports
- Published
- 2020-07-16
- Volume
- 22
- Issue
- 9
- Pages
- 45-45
- ISSN
- 1523-3804 (ISSN-L)
- 1534-6242
- OpenAlex
- W3043699463
- Cited by
- 33
- References
- 8
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 8 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 1
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Atherosclerosis Reports (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- omega-3 fatty acids, dietary supplementation, dose-response relationship, cardiovascular outcomes, myocardial infarction, stroke, sudden cardiac death, coronary revascularization, bleeding risk, atrial fibrillation, cardiovascular disease prevention, major adverse cardiovascular events, safety outcomes, cardiovascular mortality, unstable angina, gastrointestinal adverse effects
- MeSH terms
- Network Meta-Analysis, Aged, Atrial Fibrillation, Dose-Response Relationship, Drug, Female, Hemorrhage, Humans, Male, Middle Aged, Myocardial Infarction, Risk, Fatty Acids, Omega-3, Death, Sudden, Cardiac, Treatment Outcome, Dietary Supplements, Stroke
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