Abstract 4367729: Omega-3 Fatty Acid Supplementation in Patients with Prior Myocardial Infarction Receiving Statin Therapy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract
Background:
The role of omega-3 fatty acids (O3-FAs) in secondary prevention following myocardial infarction (MI) remains uncertain in the era of high-intensity statin therapy, as recent randomized controlled trials (RCTs) evaluating eicosapentaenoic acid (EPA) or combined EPA and docosahexaenoic acid (DHA) have yielded conflicting results.
Methods:
We systematically searched PubMed, Embase, and Cochrane Central for RCTs published from 2005 to May 2025, including patients with prior MI on guideline-directed statin therapy, comparing O3FAs (EPA, DHA, or both) supplementation to placebo or usual care reporting relevant outcomes. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using a random-effects model in Review Manager 9.3. We performed a subgroup analysis differentiating purified EPA studies from those with EPA/DHA combinations.
Results:
Our meta-analysis included seven randomized controlled trials, comprising a total of 12,612 patients, of whom 50% received O3-FAs. Mean age was 66 years, with 74% being male, and the mean follow-up was 3.34 years. No significant difference was observed in major adverse cardiovascular events [MACE] (HR: 0.86, 95% CI: 0.66–1.12, p = 0.20), all-cause mortality (HR: 0.96, 95% CI: 0.68–1.35, p = 0.70), or recurrent MI (HR: 0.78, 95% CI: 0.38–1.58, p = 0.27) between groups. However, subgroup analysis revealed that purified EPA supplementation significantly reduced MACE (HR: 0.73, 95% CI: 0.55–0.96, p < 0.01).
Conclusions:…
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: 12,612 participants or records.
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