Document Detail

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.
MedLine Citation:
PMID:  22493407     Owner:  NLM     Status:  MEDLINE    
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.
Sang Mi Kwak; Seung-Kwon Myung; Young Jae Lee; Hong Gwan Seo;
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  Archives of internal medicine     Volume:  172     ISSN:  1538-3679     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-09-10     Completed Date:  2012-09-21     Revised Date:  2013-10-29    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  686-94     Citation Subset:  AIM; IM    
Center for Cancer Prevention and Detection, Ilsan, Republic of Korea.
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MeSH Terms
Cardiovascular Diseases / prevention & control*
Cause of Death
Dietary Supplements*
Docosahexaenoic Acids / therapeutic use
Double-Blind Method
Eicosapentaenoic Acid / therapeutic use
Fatty Acids, Omega-3 / therapeutic use*
Randomized Controlled Trials as Topic
Secondary Prevention*
Stroke / prevention & control
Treatment Outcome
Reg. No./Substance:
0/Fatty Acids, Omega-3; 1553-41-9/Eicosapentaenoic Acid; 25167-62-8/Docosahexaenoic Acids
Seung-Kwon Myung / ; Woong Ju / ; Seung Won Oh / ; Ji-Hyun Bae / ; Young-Kyun Kim / ; Chang-Hae Park / ; Young-Jee Jeon / ; Eun-Hyun Lee / ; Yoon Jung Chang / ; Sang Min Park / ; Chun Sik Eom / ; Yeon Ji Lee / ; Hyun-Suk Jung / ; Sang Mi Kwak /
Comment In:
Arch Intern Med. 2012 Oct 8;172(18):1427; author reply 1427-8   [PMID:  23045179 ]
Arch Intern Med. 2012 May 14;172(9):694-6   [PMID:  22493410 ]
Evid Based Med. 2013 Aug;18(4):e33   [PMID:  23161504 ]
Ann Intern Med. 2012 Aug 21;157(4):JC2-3   [PMID:  22910957 ]
J Thorac Cardiovasc Surg. 2013 Oct;146(4):991-2   [PMID:  24041165 ]

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