A Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies of Eicosapentaenoic and Docosahexaenoic Long-Chain Omega-3 Fatty Acids and Coronary Heart Disease Risk
Alexander DD, Miller PE, Van Elswyk ME, Kuratko CN, Bylsma LC
Mayo Clinic proceedings · 160 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2017-01-01 · Mayo Clin Proc · vol. 92 · issue 1 · pp. 15–29
- Publisher
- Elsevier BV
- Cited
- 251 citations · more than 99% of similar papers · 3.5× the field average
- Impact
- Top 10% most cited in its field
- References
- 85 works
- Access
- Open access (hybrid journal) · CC-BY-NC-ND
- Research areas
- Fatty Acid Research and Health · Natural Products and Biological Research · Eicosanoids and Hypertension Pharmacology
- Keywords
- Medicine, Docosahexaenoic acid, Eicosapentaenoic acid, Randomized controlled trial, Coronary heart disease, Meta-analysis, Internal medicine, Cohort study, Prospective cohort study, Disease, Polyunsaturated fatty acid, Fatty acid, Biochemistry
- MeSH
- humans, coronary disease, docosahexaenoic acids, eicosapentaenoic acid, proportional hazards models, risk assessment, prospective studies, randomized controlled trials as topic
5 authors
From US
- Dominik D. Alexander · correspondingMichigan United
- Paige Elizabeth MillerEdward Hines, Jr. VA Hospital
- Mary E. Van Elswyk
- Connye N. Kuratko
- Lauren C. BylsmaMichigan United
Abstract
Objective
To conduct meta-analyses of randomized controlled trials (RCTs) to estimate the effect of eicosapentaenoic and docosahexaenoic acid (EPA+DHA) on coronary heart disease (CHD), and to conduct meta-analyses of prospective cohort studies to estimate the association between EPA+DHA intake and CHD risk.
Methods
A systematic literature search of Ovid/Medline, PubMed, Embase, and the Cochrane Library from January 1, 1947, to November 2, 2015, was conducted; 18 RCTs and 16 prospective cohort studies examining EPA+DHA from foods or supplements and CHD, including myocardial infarction, sudden cardiac death, coronary death, and angina, were identified. Random-effects meta-analysis models were used to generate summary relative risk estimates (SRREs) and 95% CIs. Heterogeneity was examined in subgroup and sensitivity analyses and by meta-regression. Dose-response was evaluated in stratified dose or intake analyses. Publication bias assessments were performed.
Results
Among RCTs, there was a nonstatistically significant reduction in CHD risk with EPA+DHA provision (SRRE=0.94; 95% CI, 0.85-1.05). Subgroup analyses of data from RCTs indicated a statistically significant CHD risk reduction with EPA+DHA provision among higher-risk populations, including participants with elevated triglyceride levels (SRRE=0.84; 95% CI, 0.72-0.98) and elevated low-density lipoprotein cholesterol (SRRE=0.86; 95% CI, 0.76-0.98). Meta-analysis of data from prospective cohort studies resulted in a statistically significant SRRE of 0.82 (95% CI, 0.74-0.92) for higher intakes of EPA+DHA and risk of any CHD event.
Conclusion
Results indicate that EPA+DHA may be associated with reducing CHD risk, with a greater benefit observed among higher-risk populations in RCTs.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC-ND).
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