Omega 3 fatty acid supplementation after myocardial infarction: a systematic review and meta-analysis

Federico Popoff1, Giselle Balaciano2, Ariel Bardach3, Daniel Comandé3, Vilma Irazola3, Hugo Norberto Catalano1, Ariel Izcovich1
1Ministry of health, Buenos Aires, Argentina
2National Ministry of Health of Argentina, Hospital Alemán, Buenos Aires, Argentina
3Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina

Tóm tắt

The purpose of this review is to examine the effect of Omega-3 Fatty acids on mortality, morbidity, and adverse events in patients with acute myocardial infarction (AMI). Data Sources: MEDLINE, EMBASE, and the Cochrane Library through May 2018. Study Selection: Randomized Controlled trials (RCT). Certainty of evidence was assessed with the GRADE system. Interventions: omega 3 fatty acids against placebo or no treatment. Primary and secondary outcomes: All-cause death, cardiovascular death, new AMI, stroke, need for therapeutic angioplasty or By-pass, new diagnosis of cancer and incidence of adverse events. For the efficacy endpoints we included 10 RCT (24,414 patients). Omega 3 fatty acids probably make little or no difference to all-cause mortality (4 studies 9141 patients RR 1.06 - CI95% 0.90 to 1.27, moderate certainty), cardiovascular mortality (3 studies 4304 patients RR 0.93 - CI95% 0.63 to 1.37, moderate certainty), new AMI (RR 1.24 CI95% 0.71 to 2.14 - moderate certainty), any cardiovascular event (RR 0.95 95%CI 0.86 to 1.05; low certainty due to risk of bias and imprecision), and stroke (RR 1.2 95%CCI 0,66–2,19 - moderate certainty). Regarding adverse events, we are uncertain if Omega 3 fatty acids improve/reduce non severe adverse events (RR 1.39 95% CI 0.36 to 5.34; very low certainty). There is probably little or no difference in the outcome suspension due to adverse events (RR 1.19 CI 95% 0.97 to 1.47; moderate certainty). For adult patients with AMI, omega 3 fatty-acids probably yield no benefit to patient important outcomes.

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