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Meta-Analysis
. 2019 Oct 30;11(11):2599.
doi: 10.3390/nu11112599.

Effect of High-Dose Marine Omega-3 Fatty Acids on Atherosclerosis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Akira Sekikawa  1 , Chendi Cui  2 , Daisuke Sugiyama  3   4 , Anthony Fabio  5 , William S Harris  6 , Xiao Zhang  7
Affiliations
Meta-Analysis

Effect of High-Dose Marine Omega-3 Fatty Acids on Atherosclerosis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Akira Sekikawa et al. Nutrients. .

Abstract

A recent randomized controlled trial (RCT), the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT), reported that high-dose marine omega-3 fatty acids (OM3) significantly reduce cardiovascular disease (CVD) outcomes, yet the mechanisms responsible for this benefit remain unknown. To test the hypothesis that high-dose OM3 is anti-atherosclerotic, we performed a systematic review and meta-analysis of RCT of high-dose OM3 on atherosclerosis. The protocol of this systematic review was registered with PROSPERO (CRD42019125566). PubMed, Embase, Cochran Central Register for Controlled Trials, and Clinicaltrials.gov databases were searched using the following criteria: adult participants, high-dose OM3 (defined as ≥3.0 g/day, or in Japan 1.8 g/day and purity ≥90%) as the intervention, changes in atherosclerosis as the outcome, and RCTs with an intervention duration of ≥6 months. A random-effects meta-analysis was used to pool estimates across studies. Among the 598 articles retrieved, six articles met our criteria. Four RCTs evaluated atherosclerosis in the coronary and two in the carotid arteries. High-dose OM3 significantly slowed the progression of atherosclerosis (standardized mean difference -1.97, 95% confidence interval -3.01, -0.94, p < 0.001). The results indicate that anti-atherosclerotic effect of high-dose OM3 is one potential mechanism in reducing CVD outcomes demonstrated in the REDUCE-IT trial.

Keywords: Marine omega-3 fatty acids; atherosclerosis; high-dose; mechanism; meta-analysis; randomized clinical trial; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart of meta-analysis.
Figure 2
Figure 2
Effect of high-dose marine omega-3 fatty acids on atherosclerosis.
Figure 3
Figure 3
Sensitivity analysis after excluding the most and second most influential studies.
Figure 4
Figure 4
Subgroup analysis of the meta-analysis.
See this image and copyright information in PMC

References

    1. Bhatt D.L., Steg P.G., Miller M., Brinton E.A., Jacobson T.A., Ketchum S.B., Doyle R.T., Jr., Juliano R.A., Jiao L., Granowitz C., et al. Cardiovascular Risk Reduction with Icosapent Ethyl for Hypertriglyceridemia. N. Engl. J. Med. 2019;380:11–22. doi: 10.1056/NEJMoa1812792. - DOI - PubMed
    1. Kromhout D., Giltay E.J., Geleijnse J.M. n–3 Fatty Acids and Cardiovascular Events after Myocardial Infarction. N. Engl. J. Med. 2010;363:2015–2026. doi: 10.1056/NEJMoa1003603. - DOI - PubMed
    1. Galan P., Kesse-Guyot E., Czernichow S., Briancon S., Blacher J., Hercberg S. Effects of B vitamins and omega 3 fatty acids on cardiovascular diseases: A randomised placebo controlled trial. BMJ. 2010;341:c6273. doi: 10.1136/bmj.c6273. - DOI - PMC - PubMed
    1. Manson J.E., Cook N.R., Lee I.M., Christen W., Bassuk S.S., Mora S., Gibson H., Albert C.M., Gordon D., Copeland T., et al. Marine n-3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer. N. Engl. J. Med. 2018 doi: 10.1056/NEJMoa1811403. - DOI - PMC - PubMed
    1. Roncaglioni M.C., Tombesi M., Avanzini F., Barlera S., Caimi V., Longoni P., Marzona I., Milani V., Silletta M.G., Tognoni G., et al. n-3 fatty acids in patients with multiple cardiovascular risk factors. N. Engl. J. Med. 2013;368:1800–1808. doi: 10.1056/NEJMoa1205409. - DOI - PubMed

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