Excessive-Dose Omega-3s Tied to Greater Possibility for Atrial Fibrillation
Taking excessive-doses of marine omega-3 fatty acids, bigger than 1 gram day-to-day, might perchance simply develop the chance for atrial fibrillation (AF), per a meta-diagnosis of linked study.
On the other hand, the chance of increasing AF looks to be “moderately tiny” for these taking 1 gram or less of fish oil per day, Christine Albert, MD, chair of the Division of Cardiology on the Smidt Heart Institute at Cedars-Sinai, Los Angeles, California, instructed theheart.org | Medscape Cardiology.
The look became printed online October 6 within the journal Circulation.
It is estimated that 7.8% of US adults — virtually 19 million in all — make a choice fish oil dietary supplements, veritably unbeknownst to their healthcare provider, the researchers present. Yet, the literature on the consequences of omega-3 fatty acid supplementation on cardiovascular outcomes are blended.
“Some, however no longer all,” sizable-scale randomized controlled trials investigating the consequences of marine omega-3 fatty acid dietary supplements on cardiovascular outcomes have reported increased risks for AF. The aptitude causes for differing findings will most certainly be dose linked, the authors present of their paper.
The blueprint of this meta-diagnosis became to “bid readability, solutions, and actionable data” to doctors and sufferers, stated Albert. The outcomes imply, on the opposite hand, that there might perchance simply no longer be a “easy reply” to whether fish oil is ethical or tainted for AF. As a replacement, the reply might perchance simply rely on the dose, she added.
Pooled Records
After screening 4049 articles and abstracts, the researchers integrated of their diagnosis 7 sizable-scale randomized controlled trials reporting cardiovascular outcomes of marine omega-3 fatty acids.
The rigors reported outcomes for AF, both as prespecified final end result, unfavourable tournament, or a motive slow hospitalization. Every had on the least 500 sufferers and a median note-up of no longer no longer up to 1 yr.
Trials examining the consequences of omega-3 fatty acids on recurrent AF in sufferers with established AF or postoperative AF were excluded.
The seven trials enrolled a total of 81,210 sufferers (imply age, 65 years; 39% females); 72.6% of participants were enrolled in scientific trials testing ≤1 gram of marine omega-3 fatty acids per day and 27.4% were enrolled in scientific trials testing >1 gram of the complement per day. The weighted reasonable note-up became 4.9 years.
General, exhaust of omega-3 fatty acids became linked to a 25% increased chance for AF (hazard ratio [HR] 1.25; 95% CI, 1.07 – 1.46; P = .013).
In analyses stratified by dose, the chance for AF became “tremendously extra pronounced” in trials testing excessive doses of marine omega-3 fatty acid dietary supplements (>1 gram per day: HR, 1.49; 95% CI, 1.04 – 2.15; P = .042) compared with these testing lower doses (≤1 gram per day: HR, 1.12; 95% CI, 1.03 – 1.22; P = .024; P for interaction < .001).
In meta-regression, the HR for AF increased per 1 gram broaden in day-to-day omega-3 fatty acid dose (HR. 1.11; 95% CI, 1.06 – 1.15; P = .001).
Possibility–Attend Balance
“This meta-diagnosis provides new evidence when it comes to the chance of AF in sufferers taking marine omega-3 fatty acid dietary supplements,” write Albert and colleagues.
“Since the excellent thing about omega-3 fatty acids furthermore looks to be dose dependent, the associated chance of AF must be balanced against the profit on atherosclerotic cardiovascular outcomes,” they imply.
They warning that the meta-diagnosis pooled mixture-stage trial data, no longer particular person affected person data. Attributable to this truth, subgroup analyses by age or other affected person stage characteristics weren’t that it’s probably you’ll perchance perchance maybe judge of.
The chance of increasing AF will increase with advancing age and is extra general in men than in females. Additional chance components embrace elevated blood stress, coronary artery disease, coronary heart failure, coronary heart valve defects, obesity, and diabetes.
The authors screech the ability chance of increasing AF with excessive doses of omega-3 fatty acid dietary supplements must be discussed with sufferers they veritably might perchance simply serene know the indicators and indicators of the condition.
The look had no explicit funding. Albert has received grants from St. Jude Clinical, Abbott, and Roche Diagnostics.
Circulation. Printed online October 6, 2021. Summary
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