Document Detail

Review: Omega-3 fatty acid supplements provide no protective benefit in cardiovascular disease.
MedLine Citation:
PMID:  22910957     Owner:  NLM     Status:  In-Data-Review    
QUESTION In patients with cardiovascular (CV) disease, are omega-3 fatty acid supplements (eicosapentaenoic acid [EPA] and docosahexaenoic acids [DHA]) effective for secondary prevention? REVIEW SCOPE Included studies compared omega-3 fatty acid supplements used for ≥ 1 year with placebo in adults ≥ 18 years of age who had a history of CV disease, and reported such outcome measures as CV events, sudden cardiac death, CV death, all-cause mortality, myocardial infarction, congestive heart failure, and transient ischemic attack (TIA) or stroke. REVIEW METHODS PubMed, EMBASE/Excerpta Medica, and Cochrane Library (all to Apr 2011), and bibliographies were searched for English-language, double-blind, placebo-controlled, randomized trials. 14 trials (n = 20 485, mean age 63 y, 79% men) met the selection criteria. Mean follow-up was 2 years, and mean daily dose of EPA or DHA was 1.7 g/d. 6 trials had Jadad scores of 5 out of 5, 7 had scores of 4, and 1 had a score of 3. MAIN RESULTS Meta-analysis showed that omega-3 fatty acids reduced CV mortality compared with placebo (Table). Groups did not differ for CV events, sudden cardiac mortality, all-cause mortality, myocardial infarction, congestive heart failure, or TIA or stroke (Table). CONCLUSION In patients with cardiovascular disease, omega-3 fatty acid supplements do not reduce adverse cardiovascular outcomes.Omega-3 fatty acids vs placebo in patients with cardiovascular (CV) disease*OutcomesNumber of trials (n)Weighted event ratesAt a mean 2 yOmega-3 fatty acidsPlaceboRRR (95% CI)NNT (CI)CV events14 (20 485)14.4%14.8%1% (-9 to 11)Not significantRelative risk (CI)Sudden cardiac mortality5 (11 668)--0.93 (0.66 to 1.30)CV mortality11 (13 927)--0.91 (0.84 to 0.99)All-cause mortality13 (20 245)--0.96 (0.90 to 1.02)Myocardial infarction11 (16 160)--0.81 (0.65 to 1.01)Congestive heart failure6 (8422)--0.92 (0.73 to 1.17)TIA or stroke7 (10 284)--1.13 (0.77 to 1.66)*- = data not provided or not calculable; TIA = transient ischemic attack; other abbreviations defined in Glossary. RRR, NNT, and CI calculated from control event rate and relative risk in article using a random-effects model.
Sharif A Halim; L Kristin Newby
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of internal medicine     Volume:  157     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  JC2-3     Citation Subset:  AIM; IM    
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