Abstract
BackgroundEffects of fish oil on systematic inflammation in chronic heart failure remain unclear. In this meta-analysis, we aimed to evaluate the influence of fish oil supplementation on circulating levels of inflammatory markers in patients with chronic heart failure.MethodsHuman randomized controlled trials, which compared the effects of fish oil supplementation with placebo in patients with chronic heart failure, were identified by systematic search of Medline, Embase, Cochrane’s library and references cited in related reviews and studies up to November 2011. Outcome measures comprised the changes of circulating inflammatory markers. Meta-analysis was performed with the fixed-effect model or random-effect model according to the heterogeneity.ResultsA total of seven trials with eight study arms were included. The pooled results indicated circulating levels of tumor necrosis factor α (SMD = -0.62, 95% CI -1.08 to -0.16, p = 0.009), interleukin 1 (SMD = -1.24, 95% CI -1.56 to -0.91, p < 0.001) and interleukin 6 (SMD = -0.81, 95% CI -1.48 to -0.14, p = 0.02) were significantly decreased after fish oil supplementation; however, high sensitivity C reactive protein, soluble intracellular adhesion molecular 1 and vascular cell adhesion molecular 1 were not significantly affected. Meta-regression and subgroup analysis results suggested the difference in dose of fish oil and follow-up duration might influence the effects of fish oil on tumor necrosis factor α and interleukin 6. Greater reduction of these two markers might be achieved in patients taking fish oil of a higher dose (over 1000 mg/day) or for a longer duration (over 4 months).ConclusionsLimited evidence suggests anti-inflammation may be a potential mechanism underlying the beneficial effects of fish oil for chronic heart failure. Further large-scale and adequately powered clinical trials are needed to confirm these effects.
Highlights
Effects of fish oil on systematic inflammation in chronic heart failure remain unclear
Study selection Studies were selected for analysis if they met the following criteria: 1) published as full-length articles in any language; 2) reported as a prospective, randomized, and placebo-controlled trial with either a parallel or a crossover design; 3) analyzed adult patients with established Chronic heart failure (CHF) who were assigned to oral fish oil supplementation or placebo for at least one month in addition to concurrent therapy; 4) reported data on levels of at least one of the following circulating inflammatory factors, including high sensitivity C reactive protein (hsCRP), tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), interleukin 1 (IL-1), soluble intracellular adhesion molecule-1 (sICAM-1) or soluble vascular cell adhesion molecule-1 (sVCAM-1)
Extracted data included study design characteristics, patient characteristics, intervention strategies
Summary
Effects of fish oil on systematic inflammation in chronic heart failure remain unclear. In this meta-analysis, we aimed to evaluate the influence of fish oil supplementation on circulating levels of inflammatory markers in patients with chronic heart failure. Chronic heart failure (CHF) is a common clinical syndrome which can be caused by various cardiovascular disorders [1,2,3]. A recent clinical trial [9] showed a statistically significant improved mortality or cardiovascular hospitalizations (-8%; p < 0.01) in patients with CHF who received additional fish oil supplementation. We aimed to evaluate the effects of fish oil on levels of the above inflammatory markers in CHF through meta-analysis of randomized, placebo-controlled clinical trials
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