Role of Omega-3 Fatty Acids in the Prevention and Treatment of Cardiovascular Diseases: A Consensus Statement from the Experts' Committee Of National Society Of Cardiometabolic Medicine

Overview

Journal Front Pharmacol

Date 2022 Dec 29

PMID 36578548

Authors

Jian-Jun Li

Ke-Fei Dou

Zhi-Guang Zhou

Dong Zhao

Ping Ye

Jia-Jun Zhao

Li-Xin Guo

Affiliations

Soon will be listed here.

Abstract

Low-density lipoprotein cholesterol (LDL-C) has been considered as the primary target for the prevention and treatment of atherosclerotic cardiovascular disease (ASCVD). However, there are still residual cardiovascular risks in some patients even if LDL-C achieves the target level. Emerging evidence suggestes that elevated triglyceride (TG) level or triglyceride-rich lipoprotein (TRL) cholesterol (TRL-C) is one of the important components of the residual cardiovascular risks. Omega-3 fatty acids have been shown to be one of the effective drugs for reducing TG. However, its efficacy in reducing the risk of ASCVD is inconsistent in large randomized clinical trials. There is lack of consensus among Experts regarding the application of omega-3 fatty acids in cardiovascular diseases including heart failure, arrhythmia, cardiomyopathy, hypertension, and sudden death. Hence, the current consensus will comprehensively and scientifically present the detailed knowledge about the omega-3 fatty acids from a variety of aspects to provide a reference for its management of omega-3 fatty acids application in the Chinese population.

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References

Zhang X, Ritonja J, Zhou N, Chen B, Li X . Omega-3 Polyunsaturated Fatty Acids Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2022; 11(11):e025071. PMC: 9238708. DOI: 10.1161/JAHA.121.025071. View

Olshansky B, Chung M, Budoff M, Philip S, Jiao L, Doyle Jr R . Mineral oil: safety and use as placebo in REDUCE-IT and other clinical studies. Eur Heart J Suppl. 2020; 22(Suppl J):J34-J48. PMC: 7537802. DOI: 10.1093/eurheartj/suaa117. View

. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2021; 45(Suppl 1):S144-S174. DOI: 10.2337/dc22-S010. View

. [Chinese guideline on the primary prevention of cardiovascular diseases]. Zhonghua Xin Xue Guan Bing Za Zhi. 2020; 48(12):1000-1038. DOI: 10.3760/cma.j.cn112148-20201009-00796. View

Grundy S, Stone N, Bailey A, Beam C, Birtcher K, Blumenthal R . 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2018; 139(25):e1082-e1143. PMC: 7403606. DOI: 10.1161/CIR.0000000000000625. View

Sharma G, Martin S, Blumenthal R . Effects of Omega-3 Fatty Acids on Major Adverse Cardiovascular Events: What Matters Most: the Drug, the Dose, or the Placebo?. JAMA. 2020; 324(22):2262-2264. DOI: 10.1001/jama.2020.22387. View

Gencer B, Djousse L, Al-Ramady O, Cook N, Manson J, Albert C . Effect of Long-Term Marine ɷ-3 Fatty Acids Supplementation on the Risk of Atrial Fibrillation in Randomized Controlled Trials of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Circulation. 2021; 144(25):1981-1990. PMC: 9109217. DOI: 10.1161/CIRCULATIONAHA.121.055654. View

Virani S, Morris P, Agarwala A, Ballantyne C, Birtcher K, Kris-Etherton P . 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2021; 78(9):960-993. DOI: 10.1016/j.jacc.2021.06.011. View

Roncaglioni M, Tombesi M, Avanzini F, Barlera S, Caimi V, Longoni P . n-3 fatty acids in patients with multiple cardiovascular risk factors. N Engl J Med. 2013; 368(19):1800-8. DOI: 10.1056/NEJMoa1205409. View

10.

Backes J, Anzalone D, Hilleman D, Catini J . The clinical relevance of omega-3 fatty acids in the management of hypertriglyceridemia. Lipids Health Dis. 2016; 15(1):118. PMC: 4957330. DOI: 10.1186/s12944-016-0286-4. View

11.

Block R, Liu L, Herrington D, Huang S, Tsai M, OConnell T . Predicting Risk for Incident Heart Failure With Omega-3 Fatty Acids: From MESA. JACC Heart Fail. 2019; 7(8):651-661. DOI: 10.1016/j.jchf.2019.03.008. View

12.

Carroll D, Roth M . Evidence for the cardioprotective effects of omega-3 Fatty acids. Ann Pharmacother. 2002; 36(12):1950-6. DOI: 10.1345/aph.1A314. View

13.

Sandesara C, Chung M, Van Wagoner D, Barringer T, Allen K, Ismail H . A Randomized, Placebo-Controlled Trial of Omega-3 Fatty Acids for Inhibition of Supraventricular Arrhythmias After Cardiac Surgery: The FISH Trial. J Am Heart Assoc. 2012; 1(3):e000547. PMC: 3487324. DOI: 10.1161/JAHA.111.000547. View

14.

Barry A, Dixon D . Omega-3 fatty acids for the prevention of atherosclerotic cardiovascular disease. Pharmacotherapy. 2021; 41(12):1056-1065. DOI: 10.1002/phar.2615. View

15.

Mozaffarian D, Marchioli R, Macchia A, Silletta M, Ferrazzi P, Gardner T . Fish oil and postoperative atrial fibrillation: the Omega-3 Fatty Acids for Prevention of Post-operative Atrial Fibrillation (OPERA) randomized trial. JAMA. 2012; 308(19):2001-11. PMC: 3694745. DOI: 10.1001/jama.2012.28733. View

16.

Albert C, Cook N, Pester J, Moorthy M, Ridge C, Danik J . Effect of Marine Omega-3 Fatty Acid and Vitamin D Supplementation on Incident Atrial Fibrillation: A Randomized Clinical Trial. JAMA. 2021; 325(11):1061-1073. PMC: 7967086. DOI: 10.1001/jama.2021.1489. View

17.

Heidarsdottir R, Arnar D, Skuladottir G, Torfason B, Edvardsson V, Gottskalksson G . Does treatment with n-3 polyunsaturated fatty acids prevent atrial fibrillation after open heart surgery?. Europace. 2010; 12(3):356-63. DOI: 10.1093/europace/eup429. View

18.

Saravanan P, Bridgewater B, West A, ONeill S, Calder P, Davidson N . Omega-3 fatty acid supplementation does not reduce risk of atrial fibrillation after coronary artery bypass surgery: a randomized, double-blind, placebo-controlled clinical trial. Circ Arrhythm Electrophysiol. 2010; 3(1):46-53. DOI: 10.1161/CIRCEP.109.899633. View

19.

Ballantyne C, Bays H, Kastelein J, Stein E, Isaacsohn J, Braeckman R . Efficacy and safety of eicosapentaenoic acid ethyl ester (AMR101) therapy in statin-treated patients with persistent high triglycerides (from the ANCHOR study). Am J Cardiol. 2012; 110(7):984-92. DOI: 10.1016/j.amjcard.2012.05.031. View

20.

Leaf A, Albert C, Josephson M, Steinhaus D, Kluger J, Kang J . Prevention of fatal arrhythmias in high-risk subjects by fish oil n-3 fatty acid intake. Circulation. 2005; 112(18):2762-8. DOI: 10.1161/CIRCULATIONAHA.105.549527. View