Effects of Omega-3 Fatty Acid Treatment on Risk for Atrial Fibrillation: An Updated Meta-Analysis of 35 Trials including 114 592 Individuals
Abuknesha NR, O'Keefe JH, Qian F, Tintle NL, Lin Y, Sun Y, Qian HZ, Aisen PS, Albert CM, Aronson WJ, Asbeutah AAA, Bischoff-Ferrari HA, Budoff MJ, Burns NR, Cardenas CA, Carlsson CM, Chew EY, Cohen NJ, Fezeu LK, Liddell A, Galan P, Hull MA, Lan TH, Lin PY, Mengelberg A, Minihane AM, Quinn JF, Sanders TAB, Scholey A, Schoenfeld DA, Sprange K, Su KP, van Dyck CH, Van Hulle CA, Vauzour D, Weber C, Welty FK, Wittert G, Harris WS
Circulation. Arrhythmia and electrophysiology · 1 citation
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
- Independent funding
- Government
- Intramural NIH HHS
- Government
- NHLBI NIH HHS
Based on 2 listed funder(s).
Publication
- Published
- 2026-07-28 · Circ Arrhythm Electrophysiol · vol. 19 · issue 8 · p. e014785
- Publisher
- Lippincott Williams & Wilkins
- Cited
- 0 citations · more than 57% of similar papers · 0.0× the field average
- References
- 74 works
- Access
- Open access (hybrid journal) · CC-BY-NC-ND
- Research areas
- Fatty Acid Research and Health · Folate and B Vitamins Research · Atrial Fibrillation Management and Outcomes
- Keywords
- Eicosapentaenoic acid, Atrial fibrillation, Docosahexaenoic acid, Incidence (geometry), Odds ratio, Randomized controlled trial, Clinical trial, Relative risk
- MeSH
- humans, atrial fibrillation, fatty acids, omega-3, docosahexaenoic acids, eicosapentaenoic acid, treatment outcome, incidence, risk assessment, risk factors, middle aged, randomized controlled trials as topic
39 authors
From US, CN, FR, CH, AU, GB, KR, TW, NZ
- Nada Abuknesha (
- James Henry O’KeefeSaint Luke's Health System; Saint Luke's Hospital
- Frank QianBoston Medical Center
- Nathan Tintle
- Yidie LinSichuan University; West China Hospital of Sichuan University
- Yue SunSichuan University; West China Hospital of Sichuan University
Abstract
Background
Recent meta-analyses of randomized controlled trials have raised concerns that treatment with omega-3 fatty acids may increase the risk of atrial fibrillation (AF). However, these meta-analyses included at most 8 trials. The aim of this current meta-analysis was to expand the search by including other eligible omega-3 randomized controlled trials with AF incidence data, incorporating both published and unpublished data.
Methods
Eligible studies were randomized controlled trials investigating daily doses of ≥500 mg/d of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Additional inclusion criteria included ≥12 months of treatment with EPA/DHA, participants ≥50 years of age, and, where possible, the absence of known AF/atrial flutter at baseline. The primary outcome was the occurrence of new-onset AF. Our primary hypothesis was that risk for AF would simultaneously depend on both omega-3 dose (above or below 1500 mg/d) and background cardiovascular disease risk status, and that their combined impact on AF risk would be synergistic.
Results
A total of 35 randomized controlled trials (37 data sets; n=114 592) were included in this meta-analysis. Only studies including patients at high-risk for cardiovascular disease who were treated with high-doses of EPA/DHA (>1500 mg/d) showed a statistically significant increase in AF risk with a pooled odds ratio (OR) of 1.43 (95% CI, 1.14-1.79) and an absolute risk difference of 0.8% (0.40%-1.1%). None of the other 3 groups showed statistically significant levels of AF risk (odds ratios, 1.07 [high risk-low dose], 1.06 [low risk-low dose], and 1.03 [low risk-high dose]).
Conclusions
This meta-analysis suggests that high-dose EPA/DHA treatment is associated with an increased risk of AF in patients at high cardiovascular disease risk, whereas low-dose EPA/DHA does not appear to increase AF risk, even in high-risk populations. Further prospective studies are needed to evaluate any potential increased risk of higher doses balanced against potential benefits.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY-NC-ND).
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