Omega-3 fatty acids in high-risk cardiovascular patients: a meta-analysis of randomized controlled trials

BMC Cardiovascular Disorders

Research Article

Ian Schiller¹  Kristian B Filion²  Nandini Dendukuri³  James M Brophy³  Michael Bielinski⁴  Fouad El Khoury⁵ 

[1] Department of Medicine, McGill University, Montreal, Quebec, Canada;Department of Medicine, McGill University, Montreal, Quebec, Canada;Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada;Department of Medicine, McGill University, Montreal, Quebec, Canada;Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada;Technology Assessment Unit, McGill University Health Center, Montreal, Quebec, Canada;Department of Medicine, McGill University, Montreal, Quebec, Canada;Technology Assessment Unit, McGill University Health Center, Montreal, Quebec, Canada;Technology Assessment Unit, McGill University Health Center, Montreal, Quebec, Canada;

关键词: Risk Ratio;    Credible Interval;    Implantable Cardioverter Defibrillator Shock;    Coronary Restenosis;    Mortality Trial;   

DOI  :  10.1186/1471-2261-10-24

 received in 2010-04-20, accepted in 2010-06-03,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundMultiple randomized controlled trials (RCTs) have examined the cardiovascular effects of omega-3 fatty acids and have provided unexplained conflicting results. A meta-analysis of these RCTs to estimate efficacy and safety and potential sources of heterogeneity may be helpful.MethodsThe Cochrane library, MEDLINE, and EMBASE were systematically searched to identify all interventional trials of omega-3 fatty acids compared to placebo or usual diet in high-risk cardiovascular patients. The primary outcome was all-cause mortality and secondary outcomes were coronary restenosis following percutaneous coronary intervention and safety. Meta-analyses were carried out using Bayesian random-effects models, and heterogeneity was examined using meta-regression.ResultsA total of 29 RCTs (n = 35,144) met our inclusion criteria, with 25 reporting mortality and 14 reporting restenosis. Omega-3 fatty acids were not associated with a statistically significant decreased mortality (relative risk [RR] = 0.88, 95% Credible Interval [CrI] = 0.64, 1.03) or with restenosis prevention (RR = 0.89, 95% CrI = 0.72, 1.06), though the probability of some benefit remains high (0.93 and 0.90, respectively). However in meta-regressions, there was a >90% probability that larger studies and those with longer follow-up were associated with smaller benefits. No serious safety issues were identified.ConclusionsAlthough not reaching conventional statistical significance, the evidence to date suggests that omega-3 fatty acids may result in a modest reduction in mortality and restenosis. However, caution must be exercised in interpreting these benefits as results were attenuated in higher quality studies, suggesting that bias may be at least partially responsible. Additional high quality studies are required to clarify the role of omega-3 fatty acid supplementation for the secondary prevention of cardiovascular disease.

【 授权许可】

Unknown   
© Filion et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.