Preventing sudden death with n-3 (omega-3) fatty acids and defibrillators.
BACKGROUND
Because interventions that prevent and treat events due to cardiovascular disease are applied to different, but overlapping, segments of the population, it can be difficult to estimate their effectiveness if formal calculations are not available.


METHODS
Markov chain analysis, including sensitivity analysis, was used with a hypothetical population resembling that of Olmsted County, MN, aged 30 to 84 in the year 2000 to compare the estimated impact of three interventions to prevent sudden death: (1) raising blood levels of n-3 (omega-3) fatty acids, (2) distributing automated external defibrillators (AEDs), and (3) implanting cardioverter defibrillators (ICDs) in appropriate candidates. The analysis was performed in 2004, 2005, and 2006.


RESULTS
Raising median n-3 fatty acid levels would be expected to lower total mortality by 6.4% (range from sensitivity analysis = 1.6% to 10.3%). Distributing AEDs would be expected to lower total mortality by 0.8% (0.2% to 1.3%), and implanting ICDs would be expected to lower total mortality by 3.3% (0.6% to 8.7%). Three fourths of the reduction in total mortality due to n-3 fatty acid augmentation would accrue from raising n-3 fatty acid levels in the healthy population.


CONCLUSIONS
Based on central values of candidacy and efficacy, raising n-3 fatty acid levels would have about eight times the impact of distributing AEDs and two times the impact of implanting ICDs. Raising n-3 fatty acid levels would also reduce rates of sudden death among the subpopulation that does not qualify for ICDs.
Kottke
Thomas E
TE
The Heart Center, Regions Hospital, St. Paul, Minnesota 55101, USA. thomas.e.kottk@healthpartners.com
Wu
Lambert A
LA
Brekke
Lee N
LN
Brekke
Mark J
MJ
White
Roger D
RD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D047548:Defibrillators / Q000600:supply & distribution*; D017147:Defibrillators, Implantable / Q000600:supply & distribution*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D006293:Health Promotion / Q000600:supply & distribution*; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D008910:Minnesota; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D015525:Fatty Acids, Omega-3