Key result
Omega-3 fatty acids reduced the relative risk of sudden cardiac death in patients with prior MI (RR 0.43; 95% CI 0.20-0.91), but increased the risk in patients with angina (RR 1.39).
Why the study?
Does dietary or supplementary intake of omega-3 fatty acids reduce sudden cardiac death in patients with coronary heart disease?
Meta-Analysis (n=20,997)
Does dietary or supplementary intake of omega-3 fatty acids reduce sudden cardiac death in patients with coronary heart disease?
Relative Risk: 0.43 (95% CI 0.2–0.91)
Omega-3 fatty acid supplementation reduces sudden cardiac death in patients with prior MI but may increase the risk in patients with angina.
Suggests targeted omega-3 post-MI but avoidance in angina; challenges uniform supplementation recommendations in CHD.
AIM: To systematically review trials concerning the effects of omega-3 fatty acids on sudden cardiac death (SCD), cardiac death, and all-cause mortality in coronary heart disease (CHD) patients. METHODS: PubMed, Embase, and the Cochrane database (1966-2007) were searched. We identified randomized controlled trials that compared dietary or supplementary intake of omega-3 fatty acids with control diet or placebo in CHD patients. Eligible studies had at least 6 months of follow-up data, and cited SCD as an end-point. Two reviewers independently assessed methodological quality. Meta-analysis of relative risk was carried out using the random effect model. RESULTS: Eight trials were identified, comprising 20,997 patients. In patients with prior myocardial infarction (MI), omega-3 fatty acids reduced relative risk (RR) of SCD (RR = 0.43; 95% CI: 0.20-0.91). In patients with angina, omega-3 fatty acids increased RR of SCD (RR = 1.39; 95% CI: 1.01-1.92). Overall, RR for cardiac death and all-cause mortality were 0.71 (95% CI: 0.50-1.00) and 0.77 (95% CI: 0.58-1.01), respectively. CONCLUSIONS: Dietary supplementation with omega-3 fatty acids reduces the incidence of sudden cardiac death in patients with MI, but may have adverse effects in angina patients.
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Zhao et al. (2009) conducted a meta-analysis in coronary heart disease (n=20,997). omega-3 fatty acids vs. control diet or placebo was evaluated on sudden cardiac death (SCD) in patients with prior myocardial infarction (RR 0.43, 95% CI 0.20-0.91). Omega-3 fatty acids reduced the relative risk of sudden cardiac death in patients with prior MI (RR 0.43; 95% CI 0.20-0.91), but increased the risk in patients with angina (RR 1.39).
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