In a meta-analysis that included nearly 70,000 patients, supplementation with omega-3 polyunsaturated fatty acids was not associated with a lower risk of all-cause death, cardiac death, sudden death, myocardial infarction or stroke.
"Treatment with marine-derived omega-3 polyunsaturated fatty acids for the prevention of major cardiovascular adverse outcomes has been supported by a number of randomized clinical trials and refuted by others," researchers wrote in background information for the study, which appears in the Sept. 12 issue of JAMA. They added the effect on cardiovascular outcomes may be due to the ability of omega-3 PUFAs to lower triglyceride levels, prevent serious arrhythmias or even decrease platelet arregation and lower blood pressure.
Guidelines issued by major societies recommend the use of omega-3 PUFAs, either as supplements or through dietary counseling, for patients after myocardial infarction, the authors added. However, the Food and Drug Administration has approved their administration only as triglyceride-lowering agents in patients with overt hypertriglyceridemia. Some European national agencies have approved omega-3 administration for cardiovascular risk modification.
"The controversy stemming from the varying labeling indications causes confusion in everyday clinical practice about whether to use these agents for cardiovascular protection," the researchers noted.
Evangelos C. Rizos, MD, PhD, of the University Hospital of Ioannina in Greece, and colleagues performed a large-scale synthesis of the available randomized evidence by conducting a systematic review and meta-analysis to determine the association between omega-3 PUFAs and major cardiovascular outcomes.
Of the 3,635 citations retrieved, 20 studies with 68,680 randomized patients were included, reporting 7,044 deaths, 3,993 cardiac deaths, 1,150 sudden deaths, 1,837 MIs and 1,490 strokes.
Analysis indicated no statistically significant association with all-cause mortality, cardiac death, sudden death, MI and stroke when all supplement studies were considered.
"In conclusion, omega-3 PUFAs are not statistically significantly associated with major cardiovascular outcomes across patient populations," the authors wrote. "Our findings do not justify the use of omega-3 as a structured intervention in everyday clinical practice or guidelines supporting dietary omega-3 PUFA administration.
"Randomized evidence will continue to accumulate in the field, yet an individual patient data meta-analysis would be more appropriate to refine possible associations related to, among others, dose, adherence, baseline intake and cardiovascular disease risk group."
The study abstract is available at http://jama.jamanetwork.com/article.aspx?articleid=1357266.
"Treatment with marine-derived omega-3 polyunsaturated fatty acids for the prevention of major cardiovascular adverse outcomes has been supported by a number of randomized clinical trials and refuted by others," researchers wrote in background information for the study, which appears in the Sept. 12 issue of JAMA. They added the effect on cardiovascular outcomes may be due to the ability of omega-3 PUFAs to lower triglyceride levels, prevent serious arrhythmias or even decrease platelet arregation and lower blood pressure.
Guidelines issued by major societies recommend the use of omega-3 PUFAs, either as supplements or through dietary counseling, for patients after myocardial infarction, the authors added. However, the Food and Drug Administration has approved their administration only as triglyceride-lowering agents in patients with overt hypertriglyceridemia. Some European national agencies have approved omega-3 administration for cardiovascular risk modification.
"The controversy stemming from the varying labeling indications causes confusion in everyday clinical practice about whether to use these agents for cardiovascular protection," the researchers noted.
Evangelos C. Rizos, MD, PhD, of the University Hospital of Ioannina in Greece, and colleagues performed a large-scale synthesis of the available randomized evidence by conducting a systematic review and meta-analysis to determine the association between omega-3 PUFAs and major cardiovascular outcomes.
Of the 3,635 citations retrieved, 20 studies with 68,680 randomized patients were included, reporting 7,044 deaths, 3,993 cardiac deaths, 1,150 sudden deaths, 1,837 MIs and 1,490 strokes.
Analysis indicated no statistically significant association with all-cause mortality, cardiac death, sudden death, MI and stroke when all supplement studies were considered.
"In conclusion, omega-3 PUFAs are not statistically significantly associated with major cardiovascular outcomes across patient populations," the authors wrote. "Our findings do not justify the use of omega-3 as a structured intervention in everyday clinical practice or guidelines supporting dietary omega-3 PUFA administration.
"Randomized evidence will continue to accumulate in the field, yet an individual patient data meta-analysis would be more appropriate to refine possible associations related to, among others, dose, adherence, baseline intake and cardiovascular disease risk group."
The study abstract is available at http://jama.jamanetwork.com/article.aspx?articleid=1357266.
Send comments to editor@nurse.com or post comments below.
