Disclosures: Gencer reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
October 19, 2021
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Omega-3 fatty acid supplementation associated with increased AF risk

Disclosures: Gencer reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Omega-3 fatty acid supplementation, especially at higher doses, was associated with elevated risk for atrial fibrillation, according to a meta-analysis of various large-scale randomized controlled trials published in Circulation.

“Marine omega-3 fatty acid supplements may have a beneficial effect on the risk of atherosclerotic cardiovascular events; however, concerns have also been raised regarding potential off-target adverse effects on atrial fibrillation,” Baris Gencer, MD, MPH, from the division of cardiology at Geneva University Hospitals, Geneva, and the Institute of Primary Health Care at the University of Bern, Switzerland, and colleagues wrote.

Graphical depiction of data presented in article.
Source: Adobe Stock

The researchers performed a meta-analysis evaluating seven randomized controlled trials conducted from 2012 to 2020. All studies assessed CV outcomes related to marine omega-3 fatty acids and reported AF results as either a prespecified outcome, adverse event or hospitalization cause. All trials analyzed had at least 500 patients and a median follow-up of at least 1 year.

There were 81,210 patients (mean age, 65 years; 39% women) with a weighted average follow-up of 4.9 years in the seven studies. Among the cohort, 72.6% of patients were enrolled in studies evaluating 1 g or less of omega-3 fatty acids per day and 27.4% patients were enrolled in studies evaluating more than 1 g per day.

Omega-3 fatty acid supplementation was associated with increased AF risk (HR = 1.25; 95% CI, 1.07-1.46; P = .013). When stratified by omega-3 dose, compared with studies evaluating smaller supplementation doses of 1 g per day or less, HRs were greatest among studies evaluating higher doses of supplementation of more than 1 g per day (HR = 1.49; 95% CI, 1.04-2.15; P = .042 vs. HR = 1.12; 95% CI, 1.03-1.22; P = .024; P for interaction < .001).

In addition, researchers noted an increased AF risk per 1 g omega-3 fatty acid supplementation increase (HR = 1.11; 95% CI, 1.06-1.15; P = .001).

According to a related press release, despite strong evidence showing significant reductions in blood triglyceride level and arthritis pain with omega-3 supplementation, most experts recommend supplementing through consuming fish several times a week.

“Since the benefit of omega-3 fatty acids also appears to be dose-dependent, the associated risk of AF should be balanced against the benefit on atherosclerotic cardiovascular outcomes,” the researchers wrote.

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