Use of supplemental long-chain omega-3 fatty acids and risk for cardiac death: An updated meta-analysis and review of research gaps

Abstract

LC-OM3 supplementation is associated with a modest reduction in cardiac death.

n-3 Polyunsaturated Fatty Acids and Cardiovascular Disease: Principles, Practices, Pitfalls, and Promises - A Contemporary Review

“…There is a suggestion that effect sizes may vary with baseline n-3 levels. In this respect, it is agreed that even potential reductions in CHD deaths of 10% "would justify treatment" of n-3 PUFA administration due to the favorable safety profile [87,91,99,100].…”

“…In comparing the results of meta-analyses, the choice of study design, which RCTs to include, and outcomes, clearly has a strong influence on result consistency, with effect sizes varying from 0.45 to 1.45 [101]. The data from the recent trials considered herein strongly support a significant modest improvement of n-3 PUFA therapy in CHD patients, which vary according to subgroups [87,91,99,100].…”

“…A large meta-analysis of 14 RCTs involving 71,899 participants compared cardiac mortality in an n-3 PUFA arm (pharmaceuticals and supplements for ≥6 months) with a control arm [100]. There were 1,613 cardiac deaths (4.48%) in the intervention arm and 1,746 cardiac deaths (4.87%) in the control arm.…”

Fats in Foods: Current Evidence for Dietary Advice

“…Recent reviews of n-3 LCPUFA in reducing the risk of CHD disease and mortality have supported modest CVD benefits [1,42,43], with some questions about the strength of the evidence and effect sizes [44]. Benefits and CHD risk reduction are most often observed among individuals at high risk of CHD, that is, those with high triglyceride levels, high total cholesterol or LDL-C, and prevalent heart failure [43][44][45] and in studies of secondary rather than primary prevention. Doses of n-3 LCPUFA of 1 g/day or more are more likely to be associated with reduced CHD risk than lower amounts.…”

Evolving Role of Non‐Statin Therapy for the Management of Dyslipidemia and Cardiovascular Risk Reduction: Past, Present, and Future

“…However, the study was not placebo‐controlled, and the study population was enrolled entirely from Japan, limiting its generalizability. A recent meta‐analysis found a 9% reduction in the risk of sudden cardiac death with O3FA supplementation, yet this was primarily influenced by clinical trials conducted before the “statin era.” The inconsistent findings in secondary prevention with O3FA led to the AHA Scientific Advisory Statement recommendation that it is “reasonable” to use O3FA in secondary prevention; however, the NLA recommended that O3FA (2‐4 g/day) be limited only to the management of very high TG levels (≥500 mg/dl) . Until additional evidence for ASCVD reduction is available, O3FA should be limited to patients with severe hypertriglyceridemia primarily to lower TG level and reduce the risk of acute pancreatitis.…”