Omega-3 polyunsaturated fatty acids supplementation and cardiovascular outcomes: do formulation, dosage, and baseline cardiovascular risk matter? An updated meta-analysis of randomized controlled trials

Casula, Manuela; Olmastroni, Elena; Gazzotti, Marta; Galimberti, Federica; Zambón, Alberto; Catapano, Alberico L.

doi:10.1016/j.phrs.2020.105060

Cited by 40 publications

(38 citation statements)

References 51 publications

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“…Although a few clinical studies have shown the effectiveness of n-3 PUFAs in high-risk patients, the benefit of n-3 PUFAs in the prevention of ASCVD remains controversial [31][32][33][34][35][36][37][38][39][40][41][42]. For primary prevention, a study of cardiovascular events in diabetes (ASCEND) [43] and a long-term outcomes study to assess STatin Residual Risk Reduction With EpaNova in HiGh Cardiovascular Risk PatienTs With Hypertriglyceridemia (STRENGTH) [44] failed to show a significant reduction in ASCVD by n-3 PUFA formulation in high risk patients.…”

Section: Discussionmentioning

confidence: 99%

Secular Decreasing Trend in Plasma Eicosapentaenoic and Docosahexaenoic Acids among Patients with Acute Coronary Syndrome from 2011 to 2019: A Single Center Descriptive Study

et al. 2021

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Despite intensive lipid-lowering interventions, patients treated with statins develop atherosclerotic cardiovascular disease (ASCVD), and these patients have an increased risk of developing recurrent cardiovascular events during follow-up. Therefore, there is a need to focus on the residual risks in patients in statin therapy to further reduce ASCVD. The aim of this study was to retrospectively investigate the 10-year trend (2011–2019) regarding changes in polyunsaturated fatty acids (PUFAs) in patients with acute coronary syndrome (ACS) in a single center. We included 686 men and 203 women with ACS admitted to Kagawa Prefectural Central Hospital. Plasma PUFAs, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), and dihomo-γ-linolenic acid (DGLA), were measured at admission for suspected ACS. A secular decreasing trend in the levels of EPA and DHA and the EPA/AA ratio, but not of AA and DGLA, was observed. The analyses based on age (>70 or <70 years) and sex showed that the decreasing trend in the levels of EPA and DHA did not depend on age and remained significant only in men. Further studies are needed to obtain robust evidence to justify that the administration of n-3 PUFA contributes to the secondary prevention of ACS.

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Section: Discussionmentioning

confidence: 99%

Secular Decreasing Trend in Plasma Eicosapentaenoic and Docosahexaenoic Acids among Patients with Acute Coronary Syndrome from 2011 to 2019: A Single Center Descriptive Study

et al. 2021

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“…The second 2019 meta-analysis of the studies, from which the REDUCE-IT study was excluded because of the comparatively high level of its omega-3 dose, showed that omega-3 supplementation was associated with lower risk of myocardial infarction by 8%, total coronary heart disease by 5%, coronary heart disease death by 8%, and cardiovascular death by 7% [37]. Further evidence of the beneficial effect of omega-3 fatty acids in reducing cardiovascular risk is also found in the results of two meta-analyses from 2020 [38,39], although there was also an associated higher risk of bleeding events and atrial fibrillation events in some instances [39].…”

Section: Polyunsaturated Omega-3 Fatty Acidsmentioning

confidence: 88%

Dietary Supplements—For Whom? The Current State of Knowledge about the Health Effects of Selected Supplement Use

Wierzejska

2021

IJERPH

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Dietary supplements are products containing nutrients sold in various medicinal forms, and their widespread use may stem from the conviction that a preparation that looks like a drug must have therapeutic properties. The aim of this scoping review is to present what is known about the effects of using selected dietary supplements in the context of chronic diseases, as well as the risks associated with their use. The literature shows that the taking of vitamin and mineral supplements by healthy people neither lowers their risk of cardiovascular diseases nor prevents the development of malignancies. Many scientific societies recognize that omega-3 fatty acids lower blood triglycerides, but whether taking them prevents heart disease is less clear-cut. Taking weight loss supplements is not an effective method of fighting obesity. Often, some supplements are increasingly sold illegally, which is then also associated with the higher risk that they may be adulterated with banned substances, thus making them even more dangerous and potentially life-threatening. Supplements are necessary in cases of nutrient deficiency; however, even though prescription is not required, their use should be recommended and monitored by a physician.

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“…In summary, bi-weekly consumption of fish (especially fatty fish) remains a cornerstone of cardiovascular prevention and should provide an average of 500 mg/d of EPA and DHA [126,127]. The use of EPA and DHA in secondary prevention does not currently rest on solid ground because of the aforementioned reasons; yet, given the scantiness of side effects, some patients could benefit from additional fish oil intake, and physicians should discuss its use with them [128].…”

Section: Omega 3 Fatty Acidsmentioning

confidence: 99%

Fatty Acids and Cardiovascular Risk. Evidence, Lack of Evidence, and Diligence

Visioli

Poli²

2020

Nutrients

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One of the most controversial areas of nutrition research relates to fats, particularly essential fatty acids, in the context of cardiovascular disease risk. A critical feature of dietary fatty acids is that they incorporate into the plasma membrane, modifying fluidity and key physiological functions. Importantly, they can reshape the bioavailability of eicosanoids and other lipid mediators, which direct cellular responses to external stimuli, such as inflammation and chronic stress conditions. This paper provides an overview of the most recent evidence, as well as historical controversies, linking fat consumption with human health and disease. We underscore current pitfalls in the area of fatty acid research and critically frame fatty acid intake in the larger context of diet and behavior. We conclude that fundamental research on fatty acids and lipids is appropriate in certain areas, but the rigor and reproducibility are lacking in others. The pros and cons are highlighted throughout the review, seeking to guide future research on the important area of nutrition, fat intake, and cardiovascular disease risk.

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Omega-3 polyunsaturated fatty acids supplementation and cardiovascular outcomes: do formulation, dosage, and baseline cardiovascular risk matter? An updated meta-analysis of randomized controlled trials

Cited by 40 publications

References 51 publications

Secular Decreasing Trend in Plasma Eicosapentaenoic and Docosahexaenoic Acids among Patients with Acute Coronary Syndrome from 2011 to 2019: A Single Center Descriptive Study

Secular Decreasing Trend in Plasma Eicosapentaenoic and Docosahexaenoic Acids among Patients with Acute Coronary Syndrome from 2011 to 2019: A Single Center Descriptive Study

Dietary Supplements—For Whom? The Current State of Knowledge about the Health Effects of Selected Supplement Use

Fatty Acids and Cardiovascular Risk. Evidence, Lack of Evidence, and Diligence

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