The DOI matches its Crossref record; 52 of the 52 references it cites were found in a registry or an index.
Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association
Open accessAbstract
Multiple randomized controlled trials (RCTs) have assessed the effects of supplementation with eicosapentaenoic acid plus docosahexaenoic acid (omega-3 polyunsaturated fatty acids, commonly called fish oils) on the occurrence of clinical cardiovascular diseases. Although the effects of supplementation for the primary prevention of clinical cardiovascular events in the general population have not been examined, RCTs have assessed the role of supplementation in secondary prevention among patients with diabetes mellitus and prediabetes, patients at high risk of cardiovascular disease, and those with prevalent coronary heart disease. In this scientific advisory, we take a clinical approach and focus on common indications for omega-3 polyunsaturated fatty acid supplements related to the prevention of clinical cardiovascular events. We limited the scope of our review to large RCTs of supplementation with major clinical cardiovascular disease end points; meta-analyses were considered secondarily. We discuss the features of available RCTs and provide the rationale for our recommendations. We then use existing American Heart Association criteria to assess the strength of the recommendation and the level of evidence. On the basis of our review of the cumulative evidence from RCTs designed to assess the effect of omega-3 polyunsaturated fatty acid supplementation on clinical cardiovascular events, we update prior recommendations for patients with prevalent coronary heart disease, and we offer recommendations, when data are available, for patients with other clinical indications, including patients with diabetes mellitus and prediabetes and those with high risk of cardiovascular disease, stroke, heart failure, and atrial fibrillation.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“There is a lack of evidence that OM3FA treatment reduces CV events in patients with hypertriglyceridemia of any severity, as recently reviewed by Siscovick and colleagues [8].”
From Omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and their mechanisms of action on apolipoprotein B-containing lipoproteins in humans: a review (2017) · cites this paper as [8]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The American Heart Association scientific statements currently recommend n-3 PUFA supplements for secondary prevention of coronary heart disease 15 and in management of hypertriglyceridemia 16 .”
From Effects of n-3 Fatty Acid Supplements in Elderly Patients After Myocardial Infarction (2021) · cites this paper as [15]
In the citing paper
“However, reduction in atherosclerosis in animal models or humans by administration of OM3FAs has not been convincingly demonstrated [8, 11].”
In the citing paper
“Based on the latest meta-analysis (17) and American Heart Association Scientific Statement (18), there is modest support for their use.”
From Cardiovascular Impact of Nutritional Supplementation With Omega-3 Fatty Acids (2021) · cites this paper as [18]
In the citing paper
“Despite extensive interest and research, there is a lack of consistent support for OM-3 dietary supplements in CV risk reduction.”
From Critical Differences Between Dietary Supplement and Prescription Omega-3 Fatty Acids: A Narrative Review (2020) · cites this paper as [23]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease
Kris-Etherton, P. M., Harris, W. S., & Appel, L. J. (2002) · Circulation · doi:10.1161/01.cir.0000038493.65177.94 · Cited by 3,707
Self-citationBurr, M. L., Gilbert, J. F., Holliday, R. M., Elwood, P. C., Fehily, A. M., Rogers, S., Sweetnam, P. M., & Deadman, N. M. (1989) · The Lancet · doi:10.1016/s0140-6736(89)90828-3 · Cited by 2,610
Yokoyama, M., Origasa, H., Matsuzaki, M., Matsuzawa, Y., Saito, Y., Ishikawa, Y., Oikawa, S., Sasaki, J., Hishida, H., Itakura, H., et al. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60527-3 · Cited by 2,516
(1999) · PubMed · Cited by 2,062
Fish Intake, Contaminants, and Human Health: Evaluating the Risks and the Benefits
Mozaffarian, D., & Rimm, E. B. (2006) · JAMA · doi:10.1001/jama.296.15.1885 · Cited by 1,966
Self-citationTriglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association
Miller, M., Stone, N. J., Ballantyne, C., Bittner, V., Criqui, M. H., Ginsberg, H. N., Goldberg, A. C., Howard, W. J., Jacobson, M. S., Kris-Etherton, P. M., et al. (2011) · Circulation · doi:10.1161/cir.0b013e3182160726 · Cited by 1,871
Self-citationOmega-3 Fatty Acids and Cardiovascular Disease
Mozaffarian, D., & Wu, J. H. Y. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.06.063 · Cited by 1,771
Self-citationGISSI-HF investigators (2008) · The Lancet · doi:10.1016/s0140-6736(08)61239-8 · Cited by 1,350
Marchioli, R., Barzi, F., Bomba, E., Chieffo, C., Di Gregorio, D., Di Mascio, R., Franzosi, M. G., Geraci, E., Levantesi, G., Maggioni, A. P., et al. (2002) · Circulation · doi:10.1161/01.cir.0000014682.14181.f2 · Cited by 1,311
Trends in the Use of Complementary Health Approaches Among Adults in the United States
Jackson, C. (2015) · Holistic Nursing Practice · doi:10.1097/hnp.0000000000000088 · Cited by 1,174
Rizos, E. C., Ntzani, E. E., Bika, E., Kostapanos, M. S., & Elisaf, M. S. (2012) · JAMA · doi:10.1001/2012.jama.11374 · Cited by 960
n–3 Fatty Acids and Cardiovascular Events after Myocardial Infarction
Kromhout, D., Giltay, E. J., & Geleijnse, J. M. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa1003603 · Cited by 936
n–3 Fatty Acids and Cardiovascular Outcomes in Patients with Dysglycemia
The ORIGIN Trial Investigators (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1203859 · Cited by 929
(2015) · PubMed · Cited by 926
National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2
Jacobson, T. A., Maki, K. C., Orringer, C. E., Jones, P. H., Kris-Etherton, P., Sikand, G., La Forge, R., Daniels, S. R., Wilson, D. P., Morris, P. B., et al. (2015) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2015.09.002 · Cited by 784
Self-citation心筋梗塞後のn-3多価不飽和脂肪酸とビタミンEの食事補給:GISSI-Prevenzione試験の結果
Marchioli, R., Valagussa, F., Franzosi, M. G., Geraci, E., Mininni, N., Nicolosi, G. L., Santini, M., Tavazzi, L., & Vecchio, C. (1999) · The Lancet · Cited by 702
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
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
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
Lack of benefit of dietary advice to men with angina: results of a controlled trial
Burr, M. L., Ashfield-Watt, P. A. L., Dunstan, F. D. J., Fehily, A. M., Breay, P., Ashton, T., Zotos, P. C., Haboubi, N. A. A., & Elwood, P. C. (2003) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601539 · Cited by 409
Chowdhury, R., Stevens, S., Gorman, D., Pan, A., Warnakula, S., Chowdhury, S., Ward, H., Johnson, L., Crowe, F., Hu, F. B., et al. (2012) · BMJ · doi:10.1136/bmj.e6698 · Cited by 379
Kwak (2012) · doi:10.1001/archinternmed.2012.262 · Cited by 368
Covington, M. B. (2004) · PubMed · Cited by 356
Schuchardt, J., Schneider, I., Meyer, H., Neubronner, J., von Schacky, C., & Hahn, A. (2011) · Lipids in Health and Disease · doi:10.1186/1476-511x-10-145 · Cited by 291
Fish oil — How does it reduce plasma triglycerides?
Shearer, G. C., Savinova, O. V., & Harris, W. S. (2012) · Biochimica et Biophysica Acta (BBA) - Molecular and Cell Biology of Lipids · doi:10.1016/j.bbalip.2011.10.011 · Cited by 285
Bioavailability of marine n-3 fatty acid formulations
Dyerberg, J., Madsen, P., Møller, J. M., Aardestrup, I., & Schmidt, E. B. (2010) · Prostaglandins, Leukotrienes and Essential Fatty Acids · doi:10.1016/j.plefa.2010.06.007 · Cited by 256
Fish Oil and Postoperative Atrial Fibrillation
Mozaffarian, D., Marchioli, R., Macchia, A., Silletta, M. G., Ferrazzi, P., Gardner, T. J., Latini, R., Libby, P., Lombardi, F., O’Gara, P. T., et al. (2012) · JAMA · doi:10.1001/jama.2012.28733 · Cited by 230
Self-citationTanaka, K., Ishikawa, Y., Yokoyama, M., Origasa, H., Matsuzaki, M., Saito, Y., Matsuzawa, Y., Sasaki, J., Oikawa, S., Hishida, H., et al. (2008) · Stroke · doi:10.1161/strokeaha.107.509455 · Cited by 217
Kowey, P. R., Reiffel, J. A., Ellenbogen, K. A., Naccarelli, G. V., & Pratt, C. M. (2010) · JAMA · doi:10.1001/jama.2010.1735 · Cited by 201
Omega 3 Fatty Acids and Cardiovascular Outcomes: Systematic Review and Meta-Analysis
Kotwal, S., Jun, M., Sullivan, D., Perkovic, V., & Neal, B. (2012) · Circulation: Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.112.966168 · Cited by 201
Davidson, M. H., Johnson, J., Rooney, M. W., Kyle, M. L., & Kling, D. F. (2012) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2012.01.002 · Cited by 191
Saravanan, P., Bridgewater, B., West, A. L., O'Neill, S. C., Calder, P. C., & Davidson, N. C. (2009) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.109.899633 · Cited by 172
Wu, J. H. Y., Lemaître, R. N., King, I. B., Song, X., Sacks, F. M., Rimm, E. B., Heckbert, S. R., Siscovick, D. S., & Mozaffarian, D. (2012) · Circulation · doi:10.1161/circulationaha.111.062653 · Cited by 143
Self-citationOmega-3 Fatty Acids for the Prevention of Recurrent Symptomatic Atrial Fibrillation
Macchia, A., Grancelli, H., Varini, S. D., Nul, D. R., Laffaye, N., Mariani, J. A., Ferrante, D., Badra, R., Figal, J. C., Ramos, S., et al. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.11.021 · Cited by 140
Oikawa, S., Yokoyama, M., Origasa, H., Matsuzaki, M., Matsuzawa, Y., Saito, Y., Ishikawa, Y., Sasaki, J., Hishida, H., Itakura, H., et al. (2009) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2009.03.029 · Cited by 125
Heidt, M. C., Vician, M., Stracke, S., Stadlbauer, T. H. W., Grebe, M., Boening, A., Vogt, P. R., & Erdogan, A. (2009) · The Thoracic and Cardiovascular Surgeon · doi:10.1055/s-0029-1185301 · Cited by 123
Bonds, D. E., Harrington, M., Worrall, B. B., Bertoni, A. G., Eaton, C. B., Hsia, J., Robinson, J., Clemons, T. E., Fine, L. J., & Chew, E. Y. (2014) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2014.328 · Cited by 118
Kromhout, D., Geleijnse, J. M., de Goede, J., Griep, L. M. O., Mulder, B. J. M., de Boer, M., Deckers, J. W., Boersma, E. H., Zock, P. L., & Giltay, E. J. (2011) · Diabetes Care · doi:10.2337/dc11-0896 · Cited by 116
Heidarsdottir, R., Arnar, D. O., Skúladóttir, G. V., Torfason, B., Edvardsson, V. O., Gottskálksson, G., Pálsson, R., & Indridason, Ó. S. (2010) · EP Europace · doi:10.1093/europace/eup429 · Cited by 113
Mariani, J. A., Doval, H. C., Nul, D. R., Varini, S. D., Grancelli, H., Ferrante, D., Tognoni, G., & Macchia, A. (2013) · Journal of the American Heart Association · doi:10.1161/jaha.112.005033 · Cited by 111
Effect of Dietary Fish Oil on Atrial Fibrillation After Cardiac Surgery
Farquharson, A. L., Metcalf, R. G., Sanders, P., Stuklis, R. G., Edwards, J. R. M., Gibson, R. A., Cleland, L. G., Sullivan, T., James, M. J., & Young, G. D. (2011) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.04.036 · Cited by 95
Fish Oil for the Reduction of Atrial Fibrillation Recurrence, Inflammation, and Oxidative Stress
Nigam, A., Talajic, M. R., Roy, D., Nattel, S., Lambert, J., Nozza, A., Jones, P. J. H., Ramprasath, V. R., O’Hara, G. E., Kopecky, S. L., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.07.956 · Cited by 93
Offman, E., Marenco, T., Ferber, S., Johnson, J., Kling, D., Curcio, D., & Davidson, M. (2013) · Vascular Health and Risk Management · doi:10.2147/vhrm.s50464 · Cited by 92
Maki, K. C., Bays, H. E., & Dicklin, M. R. (2012) · Journal of Clinical Lipidology · doi:10.1016/j.jacl.2012.04.003 · Cited by 83
Perrin, A., Simon, C., Hedelin, G., Arveiler, D., Schaffer, P., & Schlienger, J. (2002) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601322 · Cited by 79
Vanderbilt, C. M., Free, M. M., Li, J., Gebretsadik, T. S., Bian, A., Shintani, A., McBride, B. F., Solus, J. F., Milne, G. L., Crossley, G. H., et al. (2014) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2014.10.022 · Cited by 79
Sandesara, C. M., Chung, M. K., Wagoner, D. R. V., Barringer, T. A., Allen, K. B., Ismail, H. M., Zimmerman, B. M., & Olshansky, B. (2012) · Journal of the American Heart Association · doi:10.1161/jaha.111.000547 · Cited by 65
Self-citationFish Oil and Post-Operative Atrial Fibrillation
Mozaffarian, D., Wu, J. H. Y., de Oliveira Otto, M. C., Sandesara, C. M., Metcalf, R. G., Latini, R., Libby, P., Lombardi, F., O'Gara, P. T., Page, R. L., et al. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.02.045 · Cited by 57
Self-citationMarchioli, R., Marfisi, R. M., Borrelli, G., Chieffo, C., Franzosi, M. G., Levantesi, G., Maggioni, A. P., Nicolosi, G. L., Scarano, M., Silletta, M. G., et al. (2007) · Journal of Cardiovascular Medicine · doi:10.2459/01.jcm.0000289271.80180.b6 · Cited by 30
Ω-3 fatty acid supplement use in the 45 and Up Study Cohort
Adams, J., Sibbritt, D. W., Lui, C., Broom, A. F., & Wardle, J. (2013) · BMJ Open · doi:10.1136/bmjopen-2012-002292 · Cited by 28
Villani, A. M., Crotty, M., Cleland, L. G., James, M. J., Fraser, R. J., Cobiac, L., & Miller, M. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.05.054 · Cited by 10
Cited by
Sorted by citations
Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association
Virani, S. S., Alonso, A., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Delling, F. N., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000757 · Cited by 9,175
Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association
Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Das, S. R., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000659 · Cited by 9,036
Heart Disease and Stroke Statistics—2023 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Beaton, A. Z., Boehme, A. K., Buxton, A. E., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001123 · Cited by 8,300
Heart disease and stroke statistics-2018 update: a report from the american heart association
Benjamin, E. J., Virani, S. S., Callaway, C. W., Chamberlain, A. M., Chang, A. R., Cheng, S., Chiuve, S. E., Cushman, M., Delling, F. N., Deo, R., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000558 · Cited by 7,146
Self-citationHeart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., Boehme, A. K., Buxton, A. E., Carson, A. P., Commodore-Mensah, Y., et al. (2022) · Circulation · doi:10.1161/cir.0000000000001052 · Cited by 5,987
Metadata
- Authors
- Siscovick, D. S., Barringer, T. A., Fretts, A. M., Wu, J. H. Y., Lichtenstein, A. H., Costello, R. B., Kris-Etherton, P. M., Jacobson, T. A., Engler, M. B., Alger, H. M., Appel, L. J., & Mozaffarian, D.
- ORCID
- Venue
- Circulation
- Published
- 2017-04-11
- Volume
- 135
- Issue
- 15
- Pages
- e867-e884
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC6903779
- OpenAlex
- W2597054569
- Cited by
- 629
- References
- 52
- Citations by year
- 2026: 21 · 2025: 42 · 2024: 57 · 2023: 57 · 2022: 64 · 2021: 66 · 2020: 90 · 2019: 90 · 2018: 100 · 2017: 40
- FWCI
- 9.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R01HL101236, R01HL085710)
- 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
- Physical Sciences › Chemistry › Organic Chemistry › Edible Oils Quality and Analysis
- Keywords
- omega-3 polyunsaturated fatty acids, fish oil supplementation, eicosapentaenoic acid, docosahexaenoic acid, cardiovascular disease prevention, secondary prevention, coronary artery disease, diabetes mellitus, prediabetes, high cardiovascular risk, stroke, heart failure, atrial fibrillation
- MeSH terms
- Atrial Fibrillation, Cardiovascular Diseases, Diabetes Mellitus, Fish Oils, Heart Failure, Cardiac Surgical Procedures, Humans, Primary Prevention, Risk, Fatty Acids, Omega-3, Dietary Supplements, Stroke, Diabetes Complications, Secondary Prevention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review