Abstract
BackgroundResults of observational and experimental studies investigating the association between intake of long-chain n-3 polyunsaturated fatty acids (PUFAs) and risk of atrial fibrillation (AF) have been inconsistent.MethodsWe studied the association of fish and the fish-derived n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) with the risk of incident AF in individuals aged 45–64 from the Atherosclerosis Risk in Communities (ARIC) cohort (n = 14,222, 27% African Americans). Intake of fish and of DHA and EPA were measured via food frequency questionnaire. Plasma levels of DHA and EPA were measured in phospholipids in a subset of participants (n = 3,757). Incident AF was identified through the end of 2008 using ECGs, hospital discharge codes and death certificates. Cox proportional hazards regression was used to estimate hazard ratios of AF by quartiles of n-3 PUFAs or by fish intake.ResultsDuring the average follow-up of 17.6 years, 1,604 AF events were identified. In multivariable analyses, total fish intake and dietary DHA and EPA were not associated with AF risk. Higher intake of oily fish and canned tuna was associated with a nonsignificant lower risk of AF (p for trend = 0.09). Phospholipid levels of DHA+EPA were not related to incident AF. However, DHA and EPA showed differential associations with AF risk when analyzed separately, with lower risk of AF in those with higher levels of DHA but no association between EPA levels and AF risk.ConclusionsIn this racially diverse sample, dietary intake of fish and fish-derived n-3 fatty acids, as well as plasma biomarkers of fish intake, were not associated with AF risk.
Highlights
Consumption of fish and fish-derived n-3 polyunsaturated fatty acids (PUFAs) has been shown to reduce the risk of cardiovascular disease [1,2], sudden cardiac death [3]
Intake of fish and the fish-derived n-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) may reduce the risk of atrial fibrillation (AF), a common cardiac arrhythmia associated with increased stroke and cardiovascular morbidity and mortality, which affects more than 2 million Americans [7]
Using a combination of self-reported and objective measures of fish consumption in the same population might provide a more accurate representation of the association with AF risk taking advantage of the strengths of each method. We used both self-reported measures of fish and dietary EPA and DHA intake (derived from food frequency questionnaires (FFQ)) and phospholipid measures of EPA and DHA to test the hypothesis that fish and EPA and DHA are inversely associated with the risk of incident AF in the Atherosclerosis Risk in Communities (ARIC) Study, a population based cohort of middle aged American men and women
Summary
Consumption of fish and fish-derived n-3 PUFAs has been shown to reduce the risk of cardiovascular disease [1,2], sudden cardiac death [3]. Intake of fish and the fish-derived n-3 fatty acids DHA and EPA may reduce the risk of atrial fibrillation (AF), a common cardiac arrhythmia associated with increased stroke and cardiovascular morbidity and mortality, which affects more than 2 million Americans [7]. Using a combination of self-reported and objective measures (biomarkers) of fish consumption in the same population might provide a more accurate representation of the association with AF risk taking advantage of the strengths of each method We used both self-reported measures of fish and dietary EPA and DHA intake (derived from food frequency questionnaires (FFQ)) and phospholipid measures of EPA and DHA to test the hypothesis that fish and EPA and DHA are inversely associated with the risk of incident AF in the Atherosclerosis Risk in Communities (ARIC) Study, a population based cohort of middle aged American men and women. Results of observational and experimental studies investigating the association between intake of long-chain n-3 polyunsaturated fatty acids (PUFAs) and risk of atrial fibrillation (AF) have been inconsistent
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