Limits...
Effect of fish oil on arrhythmias and mortality: systematic review.

León H, Shibata MC, Sivakumaran S, Dorgan M, Chatterley T, Tsuyuki RT - BMJ (2008)

Bottom Line: The dose-response relation for DHA and EPA on reduction in deaths from cardiac causes was not significant.Fish oil supplementation was associated with a significant reduction in deaths from cardiac causes but had no effect on arrhythmias or all cause mortality.Evidence to recommend an optimal formulation of EPA or DHA to reduce these outcomes is insufficient.

View Article: PubMed Central - PubMed

Affiliation: Epidemiology Coordinating and Research (EPICORE) Centre, Edmonton, AB, Canada.

ABSTRACT

Objective: To synthesise the literature on the effects of fish oil-docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)-on mortality and arrhythmias and to explore dose response and formulation effects.

Design: Systematic review and meta-analysis.

Data sources: Medline, Embase, the Cochrane Library, PubMed, CINAHL, IPA, Web of Science, Scopus, Pascal, Allied and Complementary Medicine, Academic OneFile, ProQuest Dissertations and Theses, Evidence-Based Complementary Medicine, and LILACS. Studies reviewed Randomised controlled trials of fish oil as dietary supplements in humans.

Data extraction: The primary outcomes of interest were the arrhythmic end points of appropriate implantable cardiac defibrillator intervention and sudden cardiac death. The secondary outcomes were all cause mortality and death from cardiac causes. Subgroup analyses included the effect of formulations of EPA and DHA on death from cardiac causes and effects of fish oil in patients with coronary artery disease or myocardial infarction.

Data synthesis: 12 studies totalling 32 779 patients met the inclusion criteria. A neutral effect was reported in three studies (n=1148) for appropriate implantable cardiac defibrillator intervention (odds ratio 0.90, 95% confidence interval 0.55 to 1.46) and in six studies (n=31 111) for sudden cardiac death (0.81, 0.52 to 1.25). 11 studies (n=32 439 and n=32 519) provided data on the effects of fish oil on all cause mortality (0.92, 0.82 to 1.03) and a reduction in deaths from cardiac causes (0.80, 0.69 to 0.92). The dose-response relation for DHA and EPA on reduction in deaths from cardiac causes was not significant.

Conclusions: Fish oil supplementation was associated with a significant reduction in deaths from cardiac causes but had no effect on arrhythmias or all cause mortality. Evidence to recommend an optimal formulation of EPA or DHA to reduce these outcomes is insufficient. Fish oils are a heterogeneous product, and the optimal formulations for DHA and EPA remain unclear.

Show MeSH

Related in: MedlinePlus

Fig 2 Effect of fish oil on appropriate implantable cardiac defibrillator intervention and sudden cardiac death
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2612582&req=5

fig2: Fig 2 Effect of fish oil on appropriate implantable cardiac defibrillator intervention and sudden cardiac death

Mentions: Three studies included 1148 patients with implantable cardiac defibrillators who received fish oil or placebo (fig 2). Fish oil supplementation reduced the risk of appropriate implantable cardiac defibrillator intervention by a non-significant 10% (odds ratio 0.90, 95% confidence interval 0.55 to1.46). Six studies, totalling 31 111 patients, evaluated the effect of fish oil on the incidence of sudden cardiac death (fig 2). A non-significant reduction in sudden cardiac death was observed (odds ratio 0.81, 0.52 to 1.25).


Effect of fish oil on arrhythmias and mortality: systematic review.

León H, Shibata MC, Sivakumaran S, Dorgan M, Chatterley T, Tsuyuki RT - BMJ (2008)

Fig 2 Effect of fish oil on appropriate implantable cardiac defibrillator intervention and sudden cardiac death
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2612582&req=5

fig2: Fig 2 Effect of fish oil on appropriate implantable cardiac defibrillator intervention and sudden cardiac death
Mentions: Three studies included 1148 patients with implantable cardiac defibrillators who received fish oil or placebo (fig 2). Fish oil supplementation reduced the risk of appropriate implantable cardiac defibrillator intervention by a non-significant 10% (odds ratio 0.90, 95% confidence interval 0.55 to1.46). Six studies, totalling 31 111 patients, evaluated the effect of fish oil on the incidence of sudden cardiac death (fig 2). A non-significant reduction in sudden cardiac death was observed (odds ratio 0.81, 0.52 to 1.25).

Bottom Line: The dose-response relation for DHA and EPA on reduction in deaths from cardiac causes was not significant.Fish oil supplementation was associated with a significant reduction in deaths from cardiac causes but had no effect on arrhythmias or all cause mortality.Evidence to recommend an optimal formulation of EPA or DHA to reduce these outcomes is insufficient.

View Article: PubMed Central - PubMed

Affiliation: Epidemiology Coordinating and Research (EPICORE) Centre, Edmonton, AB, Canada.

ABSTRACT

Objective: To synthesise the literature on the effects of fish oil-docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)-on mortality and arrhythmias and to explore dose response and formulation effects.

Design: Systematic review and meta-analysis.

Data sources: Medline, Embase, the Cochrane Library, PubMed, CINAHL, IPA, Web of Science, Scopus, Pascal, Allied and Complementary Medicine, Academic OneFile, ProQuest Dissertations and Theses, Evidence-Based Complementary Medicine, and LILACS. Studies reviewed Randomised controlled trials of fish oil as dietary supplements in humans.

Data extraction: The primary outcomes of interest were the arrhythmic end points of appropriate implantable cardiac defibrillator intervention and sudden cardiac death. The secondary outcomes were all cause mortality and death from cardiac causes. Subgroup analyses included the effect of formulations of EPA and DHA on death from cardiac causes and effects of fish oil in patients with coronary artery disease or myocardial infarction.

Data synthesis: 12 studies totalling 32 779 patients met the inclusion criteria. A neutral effect was reported in three studies (n=1148) for appropriate implantable cardiac defibrillator intervention (odds ratio 0.90, 95% confidence interval 0.55 to 1.46) and in six studies (n=31 111) for sudden cardiac death (0.81, 0.52 to 1.25). 11 studies (n=32 439 and n=32 519) provided data on the effects of fish oil on all cause mortality (0.92, 0.82 to 1.03) and a reduction in deaths from cardiac causes (0.80, 0.69 to 0.92). The dose-response relation for DHA and EPA on reduction in deaths from cardiac causes was not significant.

Conclusions: Fish oil supplementation was associated with a significant reduction in deaths from cardiac causes but had no effect on arrhythmias or all cause mortality. Evidence to recommend an optimal formulation of EPA or DHA to reduce these outcomes is insufficient. Fish oils are a heterogeneous product, and the optimal formulations for DHA and EPA remain unclear.

Show MeSH
Related in: MedlinePlus