Omega-3 polyunsaturated fatty acids for patients at risk of sudden cardiac death and ventricular arrhythmias: Trial sequential analysis

Abstract

In the past months, a very large number of studies have debated the role of omega-3 polyunsaturated fatty acids (PUFAs) in cardiovascular diseases. Irrespective of which clinical indication of PUFAs is considered, early trials have often reported more favorable outcomes in patients given this supplementation but, on the other hand, more recent trials have, in many cases, suggested the ineffectiveness of the intervention. The clinical indications of PUFAs studied by the most recent reports (and particularly by meta-analyses and trial sequential analyses) include primary prevention of cardiovascular diseases, 1 Roncaglioni M.C. Tombesi M. Avanzini F. et al RPSCG (Risk and Prevention Study Collaborative Group)n-3 fatty acids in patients with multiple cardiovascular risk factors. N Engl J Med. 2013; 368: 1800-1808 Crossref PubMed Scopus (412) Google Scholar secondary prevention of cardiovascular diseases, 2 Messori A, Fadda V, Maratea D, Trippoli S. Omega-3 fatty acid supplements for secondary prevention of cardiovascular disease: from “no proof of effectiveness” to “proof of no effectiveness”. JAMA Int Med, in press. Preprint available at: http://www.osservatorioinnovazione.net/papers/omega3-jama-intmed.zip. Google Scholar postoperative atrial fibrillation in heart surgery, 3 Messori A, Fadda V, Maratea D. Supplementation of n-3 polyunsaturated fatty acids to prevent postoperative atrial fibrillation in patients subjected to heart surgery. J Thorac Cardiovasc Surg, in press. Preprint available at: http://www.osservatorioinnovazione.net/papers/pufa_jtcvs2013.pdf. Google Scholar , 4 Mariani J. Doval H.C. Nul D. et al N-3 polyunsaturated fatty acids to prevent atrial fibrillation: updated systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc. 2013; 2: e005033https://doi.org/10.1161/JAHA.112.005033 Crossref Scopus (80) Google Scholar and recurrent atrial fibrillation. 4 Mariani J. Doval H.C. Nul D. et al N-3 polyunsaturated fatty acids to prevent atrial fibrillation: updated systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc. 2013; 2: e005033https://doi.org/10.1161/JAHA.112.005033 Crossref Scopus (80) Google Scholar Do omega-3 polyunsaturated fatty acids reduce risk of sudden cardiac death and ventricular arrhythmias? A meta-analysis of randomized trialsHeart & Lung: The Journal of Cardiopulmonary and Acute CareVol. 42Issue 4PreviewOmega-3 polyunsaturated fatty acids (PUFA) have demonstrated to have antiarrhythmic properties. However, randomized studies have shown inconsistent results. Full-Text PDF Applying trial sequential analysis on a negative meta-analysis: Where is the real benefit?Heart & Lung: The Journal of Cardiopulmonary and Acute CareVol. 42Issue 5PreviewOmega-3 polyunsaturated fatty acids (PUFA) have been demonstrated to have antiarrhythmic properties. Since previous randomized studies have shown inconsistent results, we performed a meta-analysis to analyze the effect of dietary supplementation with omega-3 PUFA in preventing potentially fatal ventricular arrhythmias and sudden cardiac death. In our meta-analysis a random effects model was performed and results were expressed in terms of Odds Ratio (OR) and 95% Confidence Interval (CI) after evaluating for interstudy heterogeneity using I2 The reported data were extracted on the basis of the intention-to-treat principle. Full-Text PDF