In omega-3 fatty acid trials, EPA alone yields greater CV ri
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In a meta-analysis of omega-3 fatty acid trials, eicosapentaenoic acid monotherapy yielded the greatest reduction in CV risk vs. a combination of eicosapentaenoic acid and docosahexaenoic acid.

The effects of omega-3 fatty acids (FAs), such as eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, on cardiovascular outcomes are uncertain. Researchers aimed to determine the effectiveness of omega-3 FAs on fatal and non-fatal cardiovascular outcomes and examine the potential variability in EPA vs. EPA+DHA treatment effects.

Researchers searched EMBASE, PubMed, ClinicalTrials.gov, and Cochrane library databases and performed a meta-analysis of 38 randomized controlled trials of omega-3 FAs, stratified by EPA monotherapy and EPA+DHA therapy. They estimated random-effects rate ratios (RRs) with and rated the certainty of evidence using GRADE. The key outcomes of interest were cardiovascular mortality, non-fatal cardiovascular outcomes, bleeding, and atrial fibrillation (AF). The protocol was registered in PROSPERO.

In 149,051 participants, omega-3 FA was associated with reducing cardiovascular mortality, non-fatal myocardial infarction (MI), coronary heart disease events (CHD), major adverse cardiovascular events (MACE), and revascularization. The meta-analysis showed higher RR reductions with EPA monotherapy (0.82) than with EPA + DHA (0.94) for cardiovascular mortality, non-fatal MI, CHD events, as well for MACE and revascularization. Omega-3 FA increased incident AF. EPA monotherapy vs. control was associated with a higher risk of total bleeding and AF.

Conclusively, Omega-3 FAs reduced cardiovascular mortality and improved cardiovascular outcomes. The cardiovascular risk reduction was more prominent with EPA monotherapy than with EPA+DHA.

Source: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00277-7/fulltext
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