Should clinicians recommend omega-3 fatty acid supplements to our patients to prevent heart disease? The answer is no, according to a new meta-analysis that found omega-3 fatty acid supplements are of no value for patients with a history of coronary disease. Researchers from the United Kingdom combined data from 10 large randomized, clinical trials that included nearly 78,000 individuals (61.4% men; mean age, 64 years). There were nearly 6,300 coronary heart disease events among this group over a median of 4.4 years. Randomization to omega-3 fatty acid supplementation (eicosapentaenoic acid dose range, 226-1800 mg/d) had no significant associations with coronary heart disease death (relative risk [RR], 0.93; 95% confidence interval [CI], 0.83-1.03; P = 0.05), nonfatal myocardial infarction (RR, 0.97; 95% CI, 0.87-1.08; P = 0.43), or any coronary heart disease events (RR, 0.96; 95% CI, 0.90-1.01; P = 0.12). Omega-3 fatty acid supplements also had no effect on vascular events (RR, 0.97; 95% CI, 0.93-1.01; P = 0.10), regardless of the patient’s risk group. The authors concluded that omega-3 fatty acids “had no significant association with fatal or nonfatal coronary heart disease or any major vascular events. It provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease” (JAMA Cardiol 2018 Jan 31. doi: 10.1001/jamacardio.2017.5205. [Epub ahead of print]). The American Heart Association currently recommends omega-3 fatty acid for prevention of heart disease in high-risk patients.
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