All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network Meta-Analysis from 55 Randomized Controlled Trials

Nutrients

So Young Youn¹  Tung Hoang²  Jeongseon Kim²  So Young Bu³  Eunmi Park⁴  Jeong-Hwa Choi⁵  Eunju Park⁶  Jee-Young Yeon⁷  Seung-Min Lee⁸  Ji Yeon Min⁹  Ji-Myung Kim^1,10  In Seok Lee^1,11 

[1] Clinical Nutrition Part, Samsung Medical Center, Seoul 06351, Korea;Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang 10408, Korea;Department of Food and Nutrition, Daegu University, Gyeongsan 38453, Korea;Department of Food and Nutrition, Hannam University, Daejeon 34430, Korea;Department of Food and Nutrition, Keimyung University, Daegu 42601, Korea;Department of Food and Nutrition, Kyungnam University, Changwon 51767, Korea;Department of Food and Nutrition, Seowon University, Cheongju 28674, Korea;Department of Food and Nutrition, Yonsei University, Seoul 03722, Korea;Dietetics and Nutrition Services Team, Asan Medical Center, Seoul 05505, Korea;Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Uijeongbu 11644, Korea;Nutrition Support Team, Kyung Hee University Medical Center, Seoul 02447, Korea;

关键词: cardiovascular disease;    mortality;    statin;    omega-3;    network meta-analysis;   

DOI  :  10.3390/nu12103203

来源: DOAJ

【 摘 要 】

Statins and omega-3 supplementation have shown potential benefits in preventing cardiovascular disease (CVD), but their comparative effects on mortality outcomes, in addition to primary and secondary prevention and mixed population, have not been investigated. This study aimed to examine the effect of statins and omega-3 supplementation and indirectly compare the effects of statin use and omega-3 fatty acids on all-cause mortality and CVD death. We included randomized controlled trials (RCTs) from meta-analyses published until December 2019. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated to indirectly compare the effect of statin use versus omega-3 supplementation in a frequentist network meta-analysis. In total, 55 RCTs were included in the final analysis. Compared with placebo, statins were significantly associated with a decreased the risk of all-cause mortality (RR = 0.90, 95% CI = 0.86–0.94) and CVD death (RR = 0.86, 95% CI = 0.80–0.92), while omega-3 supplementation showed a borderline effect on all-cause mortality (RR = 0.97, 95% CI = 0.94–1.01) but were significantly associated with a reduced risk of CVD death (RR = 0.92, 95% CI = 0.87–0.98) in the meta-analysis. The network meta-analysis found that all-cause mortality was significantly different between statin use and omega-3 supplementation for overall population (RR = 0.91, 95% CI = 0.85–0.98), but borderline for primary prevention and mixed population and nonsignificant for secondary prevention. Furthermore, there were borderline differences between statin use and omega-3 supplementation in CVD death in the total population (RR = 0.92, 95% CI = 0.82–1.04) and primary prevention (RR = 0.85, 95% CI = 0.68–1.05), but nonsignificant differences in secondary prevention (RR = 0.97, 95% CI = 0.66–1.43) and mixed population (RR = 0.92, 95% CI = 0.75–1.14). To summarize, statin use might be associated with a lower risk of all-cause mortality than omega-3 supplementation. Future direct comparisons between statin use and omega-3 supplementation are required to confirm the findings.

【 授权许可】

Unknown