Current Evidence and Future Directions of Omega-3 Supplementation and Cardiovascular Disease Risk

Overview

Journal Int J Angiol

Date 2024 Feb 14

PMID 38352637

Authors

Bambang Dwiputra

Anwar Santoso

Budhi Setianto Purwowiyoto

Basuni Radi

Bashar Adi Wahyu Pandhita

Serlie Fatrin

Ade Meidian Ambari

Affiliations

Soon will be listed here.

Abstract

Omega-3 supplementation has a controversial role in the secondary prevention of cardiovascular diseases. Despite large clinical trials published over the years, the evidence of omega-3 in preventing cardiovascular diseases, especially coronary heart disease, is still inconclusive. However, recent clinical trials using higher dose of omega-3 or highly purified esters of omega-3 shows promising result, with reduction in cardiovascular death and incidence of cardiovascular disease. This review aims to summarize the possible mechanism of omega-3 in preventing cardiovascular disease and future directions of research regarding the benefit of omega-3 in cardiovascular disease.

References

Kromhout D, Bosschieter E, de Lezenne Coulander C . The inverse relation between fish consumption and 20-year mortality from coronary heart disease. N Engl J Med. 1985; 312(19):1205-9. DOI: 10.1056/NEJM198505093121901. View

Chan D, Pang J, Barrett P, Sullivan D, Burnett J, Bockxmeer F . ω-3 Fatty Acid Ethyl Esters Diminish Postprandial Lipemia in Familial Hypercholesterolemia. J Clin Endocrinol Metab. 2016; 101(10):3732-3739. DOI: 10.1210/jc.2016-2217. View

Jeansen S, Witkamp R, Garthoff J, van Helvoort A, Calder P . Fish oil LC-PUFAs do not affect blood coagulation parameters and bleeding manifestations: Analysis of 8 clinical studies with selected patient groups on omega-3-enriched medical nutrition. Clin Nutr. 2017; 37(3):948-957. DOI: 10.1016/j.clnu.2017.03.027. View

Mozaffarian D, Wu J . (n-3) fatty acids and cardiovascular health: are effects of EPA and DHA shared or complementary?. J Nutr. 2012; 142(3):614S-625S. PMC: 3278271. DOI: 10.3945/jn.111.149633. View

Arnett D, Blumenthal R, Albert M, Buroker A, Goldberger Z, Hahn E . 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019; 140(11):e563-e595. PMC: 8351755. DOI: 10.1161/CIR.0000000000000677. View

Bowman L, Mafham M, Stevens W, Haynes R, Aung T, Chen F . ASCEND: A Study of Cardiovascular Events iN Diabetes: Characteristics of a randomized trial of aspirin and of omega-3 fatty acid supplementation in 15,480 people with diabetes. Am Heart J. 2018; 198:135-144. PMC: 5971211. DOI: 10.1016/j.ahj.2017.12.006. View

Budoff M, Bhatt D, Kinninger A, Lakshmanan S, Muhlestein J, Le V . Effect of icosapent ethyl on progression of coronary atherosclerosis in patients with elevated triglycerides on statin therapy: final results of the EVAPORATE trial. Eur Heart J. 2020; 41(40):3925-3932. PMC: 7654934. DOI: 10.1093/eurheartj/ehaa652. View

Lombardi M, Carbone S, Del Buono M, Chiabrando J, Vescovo G, Camilli M . Omega-3 fatty acids supplementation and risk of atrial fibrillation: an updated meta-analysis of randomized controlled trials. Eur Heart J Cardiovasc Pharmacother. 2021; 7(4):e69-e70. PMC: 8302253. DOI: 10.1093/ehjcvp/pvab008. View

Hu Y, Hu F, Manson J . Marine Omega-3 Supplementation and Cardiovascular Disease: An Updated Meta-Analysis of 13 Randomized Controlled Trials Involving 127 477 Participants. J Am Heart Assoc. 2019; 8(19):e013543. PMC: 6806028. DOI: 10.1161/JAHA.119.013543. View

10.

Doi M, Nosaka K, Miyoshi T, Iwamoto M, Kajiya M, Okawa K . Early eicosapentaenoic acid treatment after percutaneous coronary intervention reduces acute inflammatory responses and ventricular arrhythmias in patients with acute myocardial infarction: a randomized, controlled study. Int J Cardiol. 2014; 176(3):577-82. DOI: 10.1016/j.ijcard.2014.08.055. View

11.

Rhee J, Kim E, Buring J, Kurth T . Fish Consumption, Omega-3 Fatty Acids, and Risk of Cardiovascular Disease. Am J Prev Med. 2016; 52(1):10-19. PMC: 5167636. DOI: 10.1016/j.amepre.2016.07.020. View

12.

Patel P, Patel S, Bhatt D . Cardiovascular risk reduction with icosapent ethyl. Curr Opin Cardiol. 2019; 34(6):721-727. DOI: 10.1097/HCO.0000000000000678. View

13.

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

14.

Simopoulos A . Evolutionary aspects of diet, the omega-6/omega-3 ratio and genetic variation: nutritional implications for chronic diseases. Biomed Pharmacother. 2006; 60(9):502-7. DOI: 10.1016/j.biopha.2006.07.080. View

15.

Mozaffarian D, Lemaitre R, King I, Song X, Huang H, Sacks F . Plasma phospholipid long-chain ω-3 fatty acids and total and cause-specific mortality in older adults: a cohort study. Ann Intern Med. 2013; 158(7):515-25. PMC: 3698844. DOI: 10.7326/0003-4819-158-7-201304020-00003. View

16.

Popoff F, Balaciano G, Bardach A, Comande D, Irazola V, Catalano H . Omega 3 fatty acid supplementation after myocardial infarction: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2019; 19(1):136. PMC: 6549284. DOI: 10.1186/s12872-019-1086-3. View

17.

Schunck W, Konkel A, Fischer R, Weylandt K . Therapeutic potential of omega-3 fatty acid-derived epoxyeicosanoids in cardiovascular and inflammatory diseases. Pharmacol Ther. 2017; 183:177-204. DOI: 10.1016/j.pharmthera.2017.10.016. View

18.

Golzari M, Hassan Javanbakht M, Ghaedi E, Mohammadi H, Djalali M . Effect of Eicosapentaenoic acid (EPA) supplementation on cardiovascular markers in patients with type 2 diabetes mellitus: A randomized, double-blind, placebo-controlled trial. Diabetes Metab Syndr. 2018; 12(3):411-415. DOI: 10.1016/j.dsx.2018.03.003. View

19.

Bays H, Ballantyne C, Kastelein J, Isaacsohn J, Braeckman R, Soni P . Eicosapentaenoic acid ethyl ester (AMR101) therapy in patients with very high triglyceride levels (from the Multi-center, plAcebo-controlled, Randomized, double-blINd, 12-week study with an open-label Extension [MARINE] trial). Am J Cardiol. 2011; 108(5):682-90. DOI: 10.1016/j.amjcard.2011.04.015. View

20.

Heydari B, Abdullah S, Pottala J, Shah R, Abbasi S, Mandry D . Effect of Omega-3 Acid Ethyl Esters on Left Ventricular Remodeling After Acute Myocardial Infarction: The OMEGA-REMODEL Randomized Clinical Trial. Circulation. 2016; 134(5):378-91. PMC: 4973577. DOI: 10.1161/CIRCULATIONAHA.115.019949. View