Document Detail


Fish-oil supplementation in patients with implantable cardioverter defibrillators: a meta-analysis.
MedLine Citation:
PMID:  18195289     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A recent Cochrane meta-analysis did not confirm the benefits of fish and fish oil in the secondary prevention of cardiac death and myocardial infarction. We performed a meta-analysis of randomized controlled trials that examined the effect of fish-oil supplementation on ventricular fibrillation and ventricular tachycardia to determine the overall effect and to assess whether heterogeneity exists between trials.
METHODS: We searched electronic databases (MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials, CINAHL) from inception to May 2007. We included randomized controlled trials of fish-oil supplementation on ventricular fibrillation or ventricular tachycardia in patients with implantable cardioverter defibrillators. The primary outcome was implantable cardioverter defibrillator discharge. We calculated relative risk [RR] for outcomes at 1-year follow-up for each study. We used the DerSimonian and Laird random-effects methods when there was significant heterogeneity between trials and the Mantel-Hanzel fixed-effects method when heterogeneity was negligible.
RESULTS: We identified 3 trials of 1-2 years' duration. These trials included a total of 573 patients who received fish oil and 575 patients who received a control. Meta-analysis of data collected at 1 year showed no overall effect of fish oil on the relative risk of implantable cardioverter defibrillator discharge. There was significant heterogeneity between trials. The second largest study showed a significant benefit of fish oil (relative risk [RR] 0.74, 95% confidence interval [CI] 0.56-0.98). The smallest showed an adverse tendency at 1 year (RR 1.23, 95% CI 0.92-1.65) and significantly worse outcome at 2 years among patients with ventricular tachycardia at study entry (log rank p = 0.007).
CONCLUSION: These data indicate that there is heterogeneity in the response of patients to fish-oil supplementation. Caution should be used when prescribing fish-oil supplementation for patients with ventricular tachycardia.
Authors:
David J A Jenkins; Andrea R Josse; Joseph Beyene; Paul Dorian; Michael L Burr; Roxanne LaBelle; Cyril W C Kendall; Stephen C Cunnane
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne     Volume:  178     ISSN:  1488-2329     ISO Abbreviation:  CMAJ     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-15     Completed Date:  2008-02-05     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  9711805     Medline TA:  CMAJ     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  157-64     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Division of Endocrinology, St. Michael's Hospital, Toronto, Ont. cyril.kendall@utoronto.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Death*
Defibrillators, Implantable*
Dietary Supplements*
Female
Fish Oils / administration & dosage*,  adverse effects
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / prevention & control
Primary Prevention / methods
Randomized Controlled Trials as Topic
Reference Values
Risk Assessment
Survival Rate
Tachycardia, Ventricular / diagnosis,  mortality,  therapy*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fish Oils
Comments/Corrections
Comment In:
CMAJ. 2008 Jan 15;178(2):181-2   [PMID:  18195293 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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