Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials
Abstract
Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia worldwide and it is associated with high morbidity and mortality, ultimately making it a major public health burden. Omega-3 fatty acids (O3FA) supplementation are being utilized in clinical practice to reduce cardiovascular disease (CVD) risk in patients with elevated plasma triglycerides. Safety has been, however, questioned as several cardiovascular (CV) outcomes trials of O3FA supplementation showed a potential increase of AF, when compared with placebo. In this meta-analysis of randomized controlled trials (RCTs), we investigated whether O3FA supplementation is associated with an increased risk for AF compared to placebo. We conducted a systematic search of RCTs of O3FA supplementation on CV outcomes, which also included data on the incidence of AF up to November 2020. The main endpoint of the study was the onset of AF. For inferential purposes, a frequentist pairwise meta-analysis was conducted by using Poisson regression model with random study effects. Incidence rate ratio (IRR) and 95% confidence interval (CI) were chosen over relative risk as outcome measure because of the different follow-up of the selected studies. The pairwise meta-analysis was performed with the R statistical software (4.0.0 version) using R package ‘meta’. Heterogeneity across studies was assessed with Cochran’s Q method and I testing. A threshold of P 50%. The presence of publication bias for small study effect…
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