Meta Analysis of DHA and EPA Supplementation on Cardiovascular Outcomes and Atrial Fibrillation Risk
Abstract
Cardiovascular diseases (CVD) remain to impose a main global burden of morbidity and mortality despite advances in anticipation and treatment. Omega-3 fatty acids, mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been extensively studied for potential cardioprotective effects, yet their impact on cardiovascular outcomes remains debated due to heterogeneity in formulation, dose, and patient subgroups. This meta-analysis evaluated the effects of EPA and DHA supplementation on major adverse cardiovascular events (MACE) and atrial fibrillation (AF), including postoperative AF (POAF), in patients with established CVD. A systematic search of Embase, PubMed/MEDLINE, Scopus, and Web of Science (January 2010-December 2021) identified randomized controlled trials (RCTs) of combined EPA + DHA supplementation in secondary prevention or perioperative settings. Data were synthesized using RevMan v5.3 with a random-effects model, and study quality was assessed via the Cochrane RoB 2 tool. From 3682 records, 25 RCTs (n = 25 578 patients) were included. Pooled analysis showed no significant reduction in MACE (effect estimate 0.042 ± 0.0499, Z = 0.850, 95% CI [-0.055, 0.140], p = 0.396; low heterogeneity) or AF/POAF incidence (trend toward reduction: -0.198 ± 0.1498, Z = -1.319, 95% CI [-0.491, 0.096], p = 0.187; modest heterogeneity). Neutral findings likely reflect moderate-dose combined EPA + DHA use, limited subgroup reporting on metabolic comorbidities (e.g.,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 25 participants or records.
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