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Review
. 2012 Dec;31(6):846-53.
doi: 10.1016/j.clnu.2012.05.010. Epub 2012 Jun 6.

Fish Consumption, omega-3 Fatty Acids and Risk of Heart Failure: A Meta-Analysis

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Free PMC article
Review

Fish Consumption, omega-3 Fatty Acids and Risk of Heart Failure: A Meta-Analysis

Luc Djoussé et al. Clin Nutr. .
Free PMC article

Abstract

Background & aims: While marine omega-3 fatty acids have been associated with a lower mortality in heart failure patients, data on omega-3 and incident heart failure are inconsistent. We systematically reviewed the evidence on the association of omega-3 fatty acids and fish intake with the incidence of heart failure in this meta-analysis.

Methods: We identified relevant studies by searching MEDLINE and EMBASE databases up to August 31, 2011 without restrictions and by reviewing reference lists from retrieved articles.

Results: A total of 176,441 subjects and 5480 incident cases of heart failure from 7 prospective studies were included in this analysis. Using random effect model, the pooled relative risk for heart failure comparing the highest to lowest category of fish intake was 0.85 (95% CI; 0.73-0.99), p = 0.04; corresponding value for marine omega-3 fatty acids was 0.86 (0.74-1.00), p = 0.05. There was no evidence for heterogeneity across studies of fish consumption (I(2) = 8%). In contrast, there was modest heterogeneity for omega-3 fatty acid analysis (I(2) = 44%). Lastly, there was no evidence for publication bias.

Conclusions: This meta-analysis is consistent with a lower risk of heart failure with intake of marine omega-3 fatty acids. These observational findings should be confirmed in a large randomized trial.

Conflict of interest statement

Conflict of interest

Luc Djousse: Travel reimbursement from the International Nut and Dried Fruit Foundation

Akintunde O. Akinkuolie: None

Jason H.Y. Wu: None

Eric L. Ding: None

J Michael Gaziano: None

Figures

Figure 1
Figure 1
Search and selection of studies included in the meta-analysis
Figure 2
Figure 2
Adjusted relative risks of heart failure according to the highest vs. lowest category of fish intake (Panel A) and EPA and DHA (Panel B). CI denotes confidence interval; HF: heart failure; the size of each square is proportional to the study’s weight (inverse of variance –IV).
Figure 3
Figure 3
Funnel plot assessing publication bias
Figure 4
Figure 4
Dose-response association of fish intake (Panel A) and dietary EPA+DHA with the risk of heart failure using random effects GLST analysis. Pooled relative risks (solid black lines) and 95% confidence intervals (dashed lines) at each quantity of intake are reported. Gray lines connect study-specific relative risk according to fish or EPA/DHA levels. Vertical axis is on a log scale represents relative risk. The median intake in the lowest category of fish (0 g/d) and EPA+DHA (14 mg/d) were used as reference groups to estimate the pooled relative risks of the higher levels.

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