Abstract
Purpose
Observational studies have shown an inconsistent association between n-3 polyunsaturated
fatty acids and the risk of coronary heart disease. We investigated the effects of
dietary and nondietary (supplemental) intake of n-3 polyunsaturated fatty acids on
coronary heart disease.
Subjects and methods
We searched the literature to identify randomized controlled trials that compared
dietary or nondietary intake of n-3 polyunsaturated fatty acids with a control diet
or placebo in patients with coronary heart disease. Studies had to have at least 6
months of follow-up data, and to have reported clinical endpoint data. We identified
11 trials, published between 1966 and 1999, which included 7951 patients in the intervention
and 7855 patients in the control groups.
Results
The risk ratio of nonfatal myocardial infarction in patients who were on n-3 polyunsaturated
fatty acid-enriched diets compared with control diets or placebo was 0.8 (95% confidence
interval [CI]: 0.5 to 1.2, P = 0.16; Breslow-Day test for heterogeneity, P = 0.01), and the risk ratio of fatal myocardial infarction was 0.7 (95% CI: 0.6 to
0.8, P <0.001; heterogeneity P >0.20). In 5 trials, sudden death was associated with a risk ratio of 0.7 (95% CI:
0.6 to 0.9, P <0.01; heterogeneity P >0.20), whereas the risk ratio of overall mortality was 0.8 (95% CI: 0.7 to 0.9,
P <0.001; heterogeneity P >0.20). There was no difference in summary estimates between dietary and nondietary
interventions of n-3 polyunsaturated fatty acids for all endpoints.
Conclusion
This meta-analysis suggests that dietary and nondietary intake of n-3 polyunsaturated
fatty acids reduces overall mortality, mortality due to myocardial infarction, and
sudden death in patients with coronary heart disease.
Keywords
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Article Info
Publication History
Accepted:
October 12,
2001
Received in revised form:
August 28,
2001
Received:
June 7,
2001
Footnotes
☆Supported by a grant from the University of Basel Hospitals, Byk AG, Switzerland, and Semomed AG, Switzerland.
Identification
Copyright
© 2002 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.