Do omega-3 polyunsaturated fatty acids reduce risk of sudden cardiac death and ventricular arrhythmias? A meta-analysis of randomized trials

Khoueiry, Georges; Rafeh, Nidal Abi; Sullivan, Erinmarie; Saiful, Faisal; Jaffery, Zehra; Kenigsberg, David N.; Krishnan, Subramaniam; Khanal, Sanjaya; Bekheit, Soad; Kowalski, Marcin

doi:10.1016/j.hrtlng.2013.03.006

Cited by 41 publications

(17 citation statements)

References 49 publications

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“…With respect to fish, the primary dietary source of preformed TMAO, a meta-analysis found that fish consumption correlates dose dependently with CV protection, likely because of the long-chain omega-3 content of fish 43. While it might be argued that the benefits of omega-3 ingestion are masking a genuine adverse impact of TMAO on CV risk, the impact of moderate supplemental intakes of fish omega-3 on this risk seems to be rather modest in the context of current drug therapy, primarily influencing risk for sudden death arrhythmias 44–46. Hence, these benefits would seem unlikely to overwhelm the adverse effects of TMAO if these were of important magnitude.…”

Section: Nutritional Intakes Of Tmao and Its Precursors Do Not Correlmentioning

confidence: 99%

Association of moderately elevated trimethylamine N-oxide with cardiovascular risk: is TMAO serving as a marker for hepatic insulin resistance

DiNicolantonio¹,

McCarty

O’Keefe

2019

Open Heart

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Section: Nutritional Intakes Of Tmao and Its Precursors Do Not Correlmentioning

confidence: 99%

Association of moderately elevated trimethylamine N-oxide with cardiovascular risk: is TMAO serving as a marker for hepatic insulin resistance

DiNicolantonio¹,

McCarty

O’Keefe

2019

Open Heart

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“…A meta-analysis of randomized trials, conducted on 32,919 patients, showed that when comparing omega-3 PUFAs to a placebo, there is a non-significant risk reduction for SCD and ventricular arrhythmias [ 130 ]. However, when evaluating the significance of omega-3 PUFAs efficacy it is necessary to take into consideration the omega-3 PUFA endogenous status and drugs regimen in patients, to prevent false negative conclusions.…”

Section: Anti-arrhythmic Efficacy Of the Omega-3 Pufasmentioning

confidence: 99%

Omega-3 Index and Anti-Arrhythmic Potential of Omega-3 PUFAs

et al. 2017

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Omega-3 polyunsaturated fatty acids (PUFAs), namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are permanent subjects of interest in relation to the protection of cardiovascular health and the prevention of the incidence of both ventricular and atrial arrhythmias. The purpose of this updated review is to focus on the novel cellular and molecular effects of omega-3 PUFAs, in the context of the mechanisms and factors involved in the development of cardiac arrhythmias; to provide results of the most recent studies on the omega-3 PUFA anti-arrhythmic efficacy and to discuss the lack of the benefit in relation to omega-3 PUFA status. The evidence is in the favor of omega-3 PUFA acute and long-term treatment, perhaps with mitochondria-targeted antioxidants. However, for a more objective evaluation of the anti-arrhythmic potential of omega-3 PUFAs in clinical trials, it is necessary to monitor the basal pre-interventional omega-3 status of individuals, i.e., red blood cell content, omega-3 index and free plasma levels. In the view of evidence-based medicine, it seems to be crucial to aim to establish new approaches in the prevention of cardiac arrhythmias and associated morbidity and mortality that comes with these conditions.

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“…However, 3 recent systematic reviews failed to show any antiarrhythmic effect of marine-derived n-3 PUFAs on atrial fibrillation (AF). A review of 9 RCTs by Khoueiry et al (55) that compared dietary marine-derived n-3 PUFA supplementation with placebo found no significant risk reduction in SCD or ventricular arrhythmias. Likewise, in a meta-analysis of 16 RCTs, Mariani et al (56) reported no evidence that use of n-3 PUFAs prevented either postoperative or recurrent AF.…”

Section: Unsaturated Fasmentioning

confidence: 99%

Emerging Nutrition Science on Fatty Acids and Cardiovascular Disease: Nutritionists' Perspectives

Kris-Etherton

Fleming

2015

Advances in Nutrition

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Recent dietary guidance for heart health recommends a reduction (by ∼50%) in saturated fatty acid (SFA) intake to reduce LDL cholesterol and to decrease risk of cardiovascular disease (CVD). The 2010 Dietary Guidelines for Americans recommends substituting unsaturated fat [both polyunsaturated and monounsaturated fatty acids (PUFAs and MUFAs, respectively)] for SFAs. There are many dietary options that can be implemented to replace SFAs, given the different sources of unsaturated fats in the food supply. Compelling evidence exists for the cardioprotective benefits of n-3 (ω-3) PUFAs, both marine- and plant-derived. In addition, the evidence of cardioprotective benefits of n-6 (ω-6) PUFAs is strong, whereas that for MUFAs is mixed, although there is emerging evidence of benefits. Quantitatively, lowering SFAs by 50% will require, in part, substituting food sources of n-6 and n-3 PUFAs and MUFAs for food sources of SFAs. The use of n-3 PUFAs as a replacement for SFAs will result in a shortfall in reaching the SFA goal because of the relatively low amounts that can be incorporated in the diet, even with very high n-3 PUFA substitution. SFAs also can be replaced with dietary carbohydrate and/or protein. Replacing SFAs with carbohydrate, specifically refined sources, however, has little impact on reducing CVD risk. There is evidence about the health benefits of dietary protein on CVD risk, which merits study. Dietary guidelines have advanced considerably with the "replacement of SFA with unsaturated fat message" instead of recommending decreasing SFAs alone. A key question that remains is what is the optimal mix of macronutrients to maximally reduce CVD risk.

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Do omega-3 polyunsaturated fatty acids reduce risk of sudden cardiac death and ventricular arrhythmias? A meta-analysis of randomized trials

Cited by 41 publications

References 49 publications

Association of moderately elevated trimethylamine N-oxide with cardiovascular risk: is TMAO serving as a marker for hepatic insulin resistance

Association of moderately elevated trimethylamine N-oxide with cardiovascular risk: is TMAO serving as a marker for hepatic insulin resistance

Omega-3 Index and Anti-Arrhythmic Potential of Omega-3 PUFAs

Emerging Nutrition Science on Fatty Acids and Cardiovascular Disease: Nutritionists' Perspectives

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