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Safi Ullah Khan, Ahmad Naeem Lone, Muhammad Shahzeb Khan, Salim S. Virani, Roger Scott Blumenthal, Khurram Nasir, Michael J. Miller, Erin D. Michos, Christie Mitchell Ballantyne, William E. Boden, Deepak L. Bhatt
Background The effects of omega-3 fatty acids (FAs), such as eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, on cardiovascular outcomes are uncertain. We aimed to determine the effectiveness of omega-3 FAs on fatal and non-fatal cardiovascular outcomes and examine the potential variability in EPA vs. EPA+DHA treatment effects. Methods We searched EMBASE, PubMed, ClinicalTrials.gov, and Cochrane library databases through June 7, 2021. We performed a meta-analysis of 38 randomized controlled trials of omega-3 FAs, stratified by EPA monotherapy and EPA+DHA therapy. We estimated random-effects rate ratios (RRs) with (95% confidence intervals) and rated the certainty of evidence using GRADE. The key outcomes of interest were cardiovascular mortality, non-fatal cardiovascular outcomes, bleeding, and atrial fibrillation (AF). The protocol was registered in PROSPERO (CRD42021227580). Findings In 149,051 participants, omega-3 FA was associated with reducing cardiovascular mortality (RR, 0.93 [0.88-0.98]; p = 0.01), non-fatal myocardial infarction (MI) (RR, 0.87 [0.81–0.93]; p = 0.0001), coronary heart disease events (CHD) (RR, 0.91 [0.87–0.96]; p = 0.0002), major adverse cardiovascular events (MACE) (RR, 0.95 [0.92–0.98]; p = 0.002), and revascularization (RR, 0.91 [0.87–0.95]; p = 0.0001). The meta-analysis showed higher RR reductions with EPA monotherapy (0.82 [0.68–0.99]) than with EPA + DHA (0.94 [0.89–0.99]) for cardiovascular mortality, non-fatal MI (EPA: 0.72 [0.62–0.84]; EPA+DHA: 0.92 [0.85–1.00]), CHD events (EPA: 0.73 [0.62–0.85]; EPA+DHA: 0.94 [0.89–0.99]), as well for MACE and revascularization. Omega-3 FA increased incident AF (RR, 1.26 [1.08–1.48]). EPA monotherapy vs. control was associated with a higher risk of total bleeding (RR: 1.49 [1.20–1.84]) and AF (RR, 1.35 [1.10–1.66]). Interpretation Omega-3 FAs reduced cardiovascular mortality and improved cardiovascular outcomes. The cardiovascular risk reduction was more prominent with EPA monotherapy than with EPA+DHA. Funding None.
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Khan, S. U., Lone, A. N., Khan, M. S., Virani, S. S., Blumenthal, R. S., Nasir, K., Miller, M. J., Michos, E. D., Ballantyne, C. M., Boden, W. E., & Bhatt, D. L. (2021). Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis. EClinicalMedicine, 38, 100997. https://doi.org/10.1016/j.eclinm.2021.100997
Khan, Safi Ullah, et al. "Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis." EClinicalMedicine, vol. 38, 2021, pp. 100997, https://doi.org/10.1016/j.eclinm.2021.100997.
Khan, Safi Ullah, Ahmad Naeem Lone, Muhammad Shahzeb Khan, Salim S. Virani, Roger Scott Blumenthal, Khurram Nasir, Michael J. Miller, et al. "Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis." EClinicalMedicine 38 (2021): 100997. https://doi.org/10.1016/j.eclinm.2021.100997.
Khan S. U., Lone A. N., Khan M. S. [и др.] Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis // EClinicalMedicine. — 2021. — Vol. 38. — P. 100997. — URL: https://doi.org/10.1016/j.eclinm.2021.100997
@article{khan2021effect,
title = {{Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis}},
author = {Safi Ullah Khan and Ahmad Naeem Lone and Muhammad Shahzeb Khan and Salim S. Virani and Roger Scott Blumenthal and Khurram Nasir and Michael J. Miller and Erin D. Michos and Christie Mitchell Ballantyne and William E. Boden and Deepak L. Bhatt},
journal = {EClinicalMedicine},
year = {2021},
volume = {38},
pages = {100997},
doi = {10.1016/j.eclinm.2021.100997},
url = {https://doi.org/10.1016/j.eclinm.2021.100997}
}TY - JOUR AU - Khan, Safi Ullah AU - Lone, Ahmad Naeem AU - Khan, Muhammad Shahzeb AU - Virani, Salim S. AU - Blumenthal, Roger Scott AU - Nasir, Khurram AU - Miller, Michael J. AU - Michos, Erin D. AU - Ballantyne, Christie Mitchell AU - Boden, William E. AU - Bhatt, Deepak L. TI - Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis JO - EClinicalMedicine VL - 38 SP - 100997 PY - 2021 DA - 2021/07/08 DO - 10.1016/j.eclinm.2021.100997 UR - https://doi.org/10.1016/j.eclinm.2021.100997 ER -
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