Prevention of sudden cardiac death with omega-3 fatty acids in patients with coronary heart disease: A meta-analysis of randomized controlled trials

Abstract

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.

Effects of Omega-3 Fatty Acid for Sudden Cardiac Death Prevention in Patients with Cardiovascular Disease: A Contemporary Meta-Analysis of Randomized, Controlled Trials

“…However, these earlier meta-analyses [12,14] did not have access to the most recently published large studies [8][9][10][11], and, importantly, did not report result concerning SCD [11,14]. Our results are not consistent with a previous meta analysis by Zhao which focused on examining SCD in different patients subgroups (angina and post MI).…”

“…In addition, the results of OMEGA trial [9] and alpha Omega study [8] are consistent with ours. The population enrolled in these two studies were post-MI patients, and its results do not support the conclusion of the meta analysis by Zhao [12]. In our meta-analysis, the subgroup analysis refuted the possibility that omega-3 fatty acids would benefit patient when provided in addition to current recommended therapy.…”

“…However, in the GISSI-Prevenzione trial [4], only a low to moderate proportion of patients received modern interventional and medical treatment. Moreover, multiple recent publication of randomized controlled trials [8][9][10] and meta-analyses [11,12] have been conducted in efforts to elucidate the effect of omega-3 fatty acids on SCD, and results are conflicting with both positive [12] and negative effects reported [8][9][10][11]13].…”

OMEGA, a Randomized, Placebo-Controlled Trial to Test the Effect of Highly Purified Omega-3 Fatty Acids on Top of Modern Guideline-Adjusted Therapy After Myocardial Infarction

“…Although pooled data of previous randomized trials with a high proportion of myocardial infarction patients even showed a risk reduction for SCD of 57%, these studies were not based on current guideline-adjusted therapy of acute myocardial infarction. 22 As a consequence, the anticipated power of 80% could not be achieved in this study. Assuming a lower risk reduction for SCD by omega-3 fatty acids of 30% instead of 45%, the number of patients needed to achieve a power of 80% increases to Ϸ20 000, an extension that could not be realized within the setting of this trial.…”

Role of n-3 series polyunsaturated fatty acids in cardiovascular disease prevention

“…Clinically, it does not pose a significantly increased risk of bleeding for patients undergoing coronary artery bypass grafting, carotid endarterectomy, or femoral artery catheterization, even at high doses combined with antiplatelet therapy or warfarin, 27 though it may have adverse effects in patients with angina. 49 The most commonly observed side effects are nausea, gastrointestinal symptoms, fish-scented halitosis, and dysgeusia, which are not considered as major health hazards. 42 There is also some concern about ingestion of mercury when fishes are eaten, particularly for species like shark and swordfish.…”