Fish Oil and Postoperative Atrial Fibrillation

Mozaffarian, Dariush; Marchioli, Roberto; Macchia, Alejandro; Silletta, Maria Giuseppina; Ferrazzi, Paolo; Gardner, Timothy J.; Latini, Roberto; Libby, Peter; Lombardi, Federico; O’Gara, Patrick T.; Page, Richard L.; Tavazzi, Luigi; Tognoni, Gianni; Investigators, for the OPERA

doi:10.1001/jama.2012.28733

Cited by 196 publications

(76 citation statements)

References 46 publications

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“…8, 9, 20, 21 Our findings that n3-PUFAs as adjunctive therapy did not prevent recurrence of AF are, however, concordant with studies in postoperative AF, 22, 23 and several randomized controlled clinical trials of persistent or paroxysmal AF 10, 13, 14 , as well as a recent meta-analysis. 24 Clinical trials of n3-PUFAs to prevent AF recurrence used a range of doses and differed in design.…”

Section: Discussionsupporting

confidence: 87%

Effect of Omega-Three Polyunsaturated Fatty Acids on Inflammation, Oxidative Stress, and Recurrence of Atrial Fibrillation

Darghosian

Free

et al. 2015

The American Journal of Cardiology

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The efficacy of n-3 PUFAs in preventing recurrence of atrial fibrillation (AF) is controversial and their effects on inflammation and oxidative stress in this population are not known. This study examined the effects of high-dose marine omega-3 polyunsaturated fatty acids (n-3 PUFAs) added to conventional therapy on the recurrence of AF and on markers of inflammation and oxidative stress. Patients with paroxysmal or persistent AF were randomized to n-3 PUFAs (4g/d) (n=126) or placebo (n=64) in a 2:1 ratio in a prospective, double-blind, placebo-controlled, parallel group study. The primary outcome was time to recurrence of AF. Secondary outcomes were changes in biomarkers of inflammation (serum interleukin (IL)-6, IL-8, IL-10, tissue necrosis factor alpha (TNFα), monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF)), N-terminal-pro-brain type natriuretic peptide (NTpBNP), and oxidative stress (urinary F2–isoprostanes (IsoPs)). Atrial fibrillation recurred in 74 (58.7%) patients randomized to n3-PUFAs and in 30 (46.9%) who received placebo; time to recurrence of AF did not differ significantly in the two groups (hazard ratio 1.20; 95% CI 0.76 - 1.90, adjusted P=0.438). Compared to placebo, n3-PUFAs did not result in clinically meaningful changes in concentrations of inflammatory markers, NTpBNP or F2-Isops. In conclusion, in patients with paroxysmal or persistent AF treatment with n3-PUFAs 4g/day did not reduce the recurrence of AF, nor was it associated with clinically important effects on concentrations of markers of inflammation and oxidative stress.

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Section: Discussionsupporting

confidence: 87%

Effect of Omega-Three Polyunsaturated Fatty Acids on Inflammation, Oxidative Stress, and Recurrence of Atrial Fibrillation

Darghosian

Free

et al. 2015

The American Journal of Cardiology

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“…More recently, the results of two large studies, i.e. OPERA and FORWARD, showed no benefit of fish oil for POAF prevention and AF recurrence rates, respectively [29,30]. …”

Section: Discussionmentioning

confidence: 99%

Do High Levels of n-3 Polyunsaturated Fatty Acids in Cell Membranes Increase the Risk of Postoperative Atrial Fibrillation?

Björgvinsdóttir

Arnar²,

Indridason³

et al. 2013

Cardiology

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Objectives: Postoperative atrial fibrillation (POAF) has been associated with an inflammatory response to the surgical procedure. n-3 long-chain polyunsaturated fatty acids (LC-PUFA) have been proposed for the prevention of POAF. We investigated the relationship between the plasma concentration of inflammatory mediators, levels of n-3 LC-PUFA in red blood cell (RBC) membrane lipids, and the risk of POAF after coronary artery bypass grafting (CABG). Methods: A total of 125 patients who underwent CABG were studied. Inflammatory mediators in plasma and the content of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in RBC membranes were assessed. Results: Sixty-two patients (49.6%) developed POAF. The POAF group had higher RBC levels of total n-3 LC-PUFA and DHA than did patients remaining in sinus rhythm (p < 0.05). Of the inflammatory mediators, only postoperative interleukin-6 levels differed, being higher in the POAF group (p < 0.05). Inflammatory mediators were not independent predictors of POAF by multivariable logistic regression analysis. Higher levels of DHA and total n-3 LC-PUFA in RBC membranes, measured immediately prior to CABG and on postoperative day 3, were linearly associated with an increased risk of POAF (p < 0.05). Conclusions: Our findings suggest that inflammatory mediators are not associated with the occurrence of POAF. Interestingly, high n-3 LC-PUFA levels in RBC membranes appear to increase the risk of POAF.

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“…25,26 The primary analyses demonstrated no beneficial or harmful effect of luteinϩzeaxanthin for the treatment of advanced AMD. The exploratory analyses demonstrated results that suggest that the role of luteinϩzeaxanthin needs to be examined further.…”

Section: P Valuementioning

confidence: 98%

Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration

2013

JAMA

1,037

352

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R degeneration (AMD), the leading cause of blindness in the developed world, accounts for more than 50% of all blindness in the United States. 1 In 2004, it was estimated that 8 million individuals had intermediate AMD, defined as bilateral drusen, and approximately 2 million had advanced AMD, either neovascular AMD or geographic atrophy. 2 Although intraocular drugs that inhibit vascular endothelial growth factor are currently available for treatment of neovascular AMD, 3 no effective therapies are proven for atrophic AMD. Without more effective ways of slowing progression, the number of persons with advanced AMD is expected to double over the next 20 years, resulting in increasing socioeconomic burden. 2 The Age-Related Eye Disease Study (AREDS) demonstrated that daily oral supplementation with antioxidant vitamins and minerals reduced the risk of developing advanced AMD by 25% at 5 years. 4 Animal studies 5-7 and epidemiologic studies provide a rationale for examining the potential effects of other nutrients on the development of advanced AMD. Observational studies suggest that higher dietary intake of lutein ϩ zeaxanthin, omega-3 longchain polyunsaturated fatty acids (docosahexaenoic acid [DHA] and eicosapentaenoic acid [EPA]), or both are associated with a decreased risk of developing advanced AMD. [8][9][10][11] Lutein and zeaxanthin are the main components of the macular pigment, DHA is a ma-*The authors/members of the Age-Related Eye Disease Study 2 (AREDS2) Writing Team are listed at the end of this article. Members of the AREDS2 Research Group are listed in the eAppendix available at http: //www.jama.com.

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Fish Oil and Postoperative Atrial Fibrillation

Cited by 196 publications

References 46 publications

Effect of Omega-Three Polyunsaturated Fatty Acids on Inflammation, Oxidative Stress, and Recurrence of Atrial Fibrillation

Effect of Omega-Three Polyunsaturated Fatty Acids on Inflammation, Oxidative Stress, and Recurrence of Atrial Fibrillation

Do High Levels of n-3 Polyunsaturated Fatty Acids in Cell Membranes Increase the Risk of Postoperative Atrial Fibrillation?

Lutein + Zeaxanthin and Omega-3 Fatty Acids for Age-Related Macular Degeneration

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