Sharif A. Halim, MD; L. Kristin Newby, MD, MHS
In patients with cardiovascular (CV) disease, are omega-3 fatty acid supplements (eicosapentaenoic acid [EPA] and docosahexaenoic acids [DHA]) effective for secondary prevention?
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.
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.
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).
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*
*– = 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.
Halim SA, Newby LK. Review: Omega-3 fatty acid supplements provide no protective benefit in cardiovascular disease. Ann Intern Med. ;157:JC2–3. doi: 10.7326/0003-4819-157-4-201208210-02003
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Published: Ann Intern Med. 2012;157(4):JC2-3.
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