Prevention of Sudden Cardiac Death With omega-3 Fatty Acids in Patients With Coronary Heart Disease: A Meta-Analysis of Randomized Controlled Trials

Ann Med. 2009;41(4):301-10. doi: 10.1080/07853890802698834.

Abstract

Aim: To systematically review trials concerning the effects of omega-3 fatty acids on sudden cardiac death (SCD), cardiac death, and all-cause mortality in coronary heart disease (CHD) patients.

Methods: PubMed, Embase, and the Cochrane database (1966-2007) were searched. We identified randomized controlled trials that compared dietary or supplementary intake of omega-3 fatty acids with control diet or placebo in CHD patients. Eligible studies had at least 6 months of follow-up data, and cited SCD as an end-point. Two reviewers independently assessed methodological quality. Meta-analysis of relative risk was carried out using the random effect model.

Results: Eight trials were identified, comprising 20,997 patients. In patients with prior myocardial infarction (MI), omega-3 fatty acids reduced relative risk (RR) of SCD (RR = 0.43; 95% CI: 0.20-0.91). In patients with angina, omega-3 fatty acids increased RR of SCD (RR = 1.39; 95% CI: 1.01-1.92). Overall, RR for cardiac death and all-cause mortality were 0.71 (95% CI: 0.50-1.00) and 0.77 (95% CI: 0.58-1.01), respectively.

Conclusions: Dietary supplementation with omega-3 fatty acids reduces the incidence of sudden cardiac death in patients with MI, but may have adverse effects in angina patients.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angina Pectoris / diet therapy
  • Coronary Disease / complications
  • Coronary Disease / mortality
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control*
  • Dietary Supplements
  • Fatty Acids, Omega-3 / therapeutic use*
  • Humans
  • Myocardial Infarction / diet therapy
  • Randomized Controlled Trials as Topic

Substances

  • Fatty Acids, Omega-3