ReviewN-3 polyunsaturated fatty acids in coronary heart disease: a meta-analysis of randomized controlled trials☆
Section snippets
Methods
We searched MEDLINE, EMBASE, Pascal BioMed, and Index Medicus for all randomized controlled trials, published in all languages from 1966 through August 1999, which compared n-3 polyunsaturated fatty acids, given either as supplements or via dietary intervention, with placebo or a control diet. We combined the terms omega 3 fatty acids, fish oils, diet, dietary therapy, and cardiovascular disease with text searches using the terms random or control. We also searched the Cochrane Library and
Results
Our literature search identified 406 studies, and 369 additional articles were reviewed in the Cochrane Library. We identified 177 trials, and excluded 129 that were not related to coronary heart disease, 26 that had a follow-up of less than 6 months or did not report clinical endpoint data, and 7 that were duplicate publications. Four studies included patients who had undergone heart transplantation or bypass surgery, and were therefore also excluded.
Eleven trials fulfilled our inclusion
Discussion
Our meta-analysis suggests that a diet supplemented with n-3 polyunsaturated fatty acids may decrease mortality due to myocardial reinfarction, sudden death, and overall mortality in patients with coronary heart disease. The risk reduction for mortality was statistically significant. The mortality in control groups of trials that followed patients for an average of 1.5 years varied from 1% to 22%, suggesting that in low-risk patients (e.g., those aged <50 years and with minor uncomplicated
Acknowledgements
The authors would like to thank Peter Wolf, PhD, for conducting the literature search and Odd Johansen, MD, for providing additional data from his study.
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Supported by a grant from the University of Basel Hospitals, Byk AG, Switzerland, and Semomed AG, Switzerland.