Effects of Omega-3 Fatty Acid for Sudden Cardiac Death Prevention in Patients with Cardiovascular Disease: A Contemporary Meta-Analysis of Randomized, Controlled Trials.
Summary of "Effects of Omega-3 Fatty Acid for Sudden Cardiac Death Prevention in Patients with Cardiovascular Disease: A Contemporary Meta-Analysis of Randomized, Controlled Trials."
PURPOSE:
Experimental and epidemiological studies suggest that omega-3 fatty acids have an antiarrhythmic effect. However, evidence from randomized controlled trials (RCTs) for prevention of sudden cardiac death (SCD) remains controversial. This study sought to evaluate the efficacy of omega-3 fatty acids for secondary prevention of SCD in patients with cardiovascular disease (CVD) in the era of guidelines-based therapy.
METHODS:
We conducted a PubMed/EMBASE/CENTRAL search for RCTs evaluating omega-3 fatty acids for CVD secondary prevention with at least 6 months follow-up and with data on SCD. Primary outcome was SCD. Secondary outcomes were cardiovascular mortality and all-cause mortality.
RESULTS:
Ten randomized controlled trials were identified evaluating a total of 33,429 patients with CVD. In patients with guidelines-adjusted therapy, omega-3 fatty acids did not reduce the risk ratio (RR) of SCD (
RR:
0.96; 95%
CI:
0.84-1.10). In patients with non- guidelines-adjusted therapy, omega-3 fatty acids reduced the RR of SCD (
RR:
0.64; 95%
CI:
0.51-0.80). Overall, RR for cardiac death and all-cause mortality were 0.81 (95%
CI:
0.69-0.95) and 0.89 (95%
CI:
0.79-1.01), respectively.
CONCLUSIONS:
In the era of guidelines-adjusted treatment for CVD secondary prevention, omega-3 fatty acids do not appear to reduce SCD.
Affiliation
Institute of Geriatric Cardiology, The General Hospital of the People's Liberation Army, 28 Fuxing Road, Beijing, Country, cqwpp@126.com.
Journal Details
This article was published in the following journal.
Name: Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy
ISSN: 1573-7241
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21626218
- DOI: http://dx.doi.org/10.1007/s10557-011-6306-8
Medical and Biotech [MESH] Definitions
Death, Sudden, Cardiac
Unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. It is usually caused by the worsening of existing heart diseases. The sudden onset of symptoms, such as CHEST PAIN and CARDIAC ARRHYTHMIAS, particularly VENTRICULAR TACHYCARDIA, can lead to the loss of consciousness and cardiac arrest followed by biological death. (from Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., 2005)
Fatty Acids, Omega-6
FATTY ACIDS which have the first unsaturated bond in the sixth position from the omega carbon. A typical American diet tends to contain substantially more omega-6 than OMEGA-3 FATTY ACIDS.
Myocarditis
Inflammatory processes of the muscular walls of the heart (MYOCARDIUM) which result in injury to the cardiac muscle cells (MYOCYTES, CARDIAC). Manifestations range from subclinical to sudden death (DEATH, SUDDEN). Myocarditis in association with cardiac dysfunction is classified as inflammatory CARDIOMYOPATHY usually caused by INFECTION, autoimmune diseases, or responses to toxic substances. Myocarditis is also a common cause of DILATED CARDIOMYOPATHY and other cardiomyopathies.
Fatty Acids, Omega-3
A group of fatty acids, often of marine origin, which have the first unsaturated bond in the third position from the omega carbon. These fatty acids are believed to reduce serum triglycerides, prevent insulin resistance, improve lipid profile, prolong bleeding times, reduce platelet counts, and decrease platelet adhesiveness.
Commotio Cordis
A sudden CARDIAC ARRHYTHMIA (e.g., VENTRICULAR FIBRILLATION) caused by a blunt, non-penetrating impact to the precordial region of chest wall. Commotio cordis often results in sudden death without prompt cardiopulmonary defibrillation.
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