Prevention of sudden cardiac death with omega-3 fatty acids in patients with coronary heart disease: a meta-analysis of randomized controlled trials.
OBJECTIVE
To systematically review trials concerning the effects of omega-3 fatty acids on sudden cardiac death (SCD), cardiac death, and all-cause mortality in coronary heart disease (CHD) patients.


METHODS
PubMed, Embase, and the Cochrane database (1966-2007) were searched. We identified randomized controlled trials that compared dietary or supplementary intake of omega-3 fatty acids with control diet or placebo in CHD patients. Eligible studies had at least 6 months of follow-up data, and cited SCD as an end-point. Two reviewers independently assessed methodological quality. Meta-analysis of relative risk was carried out using the random effect model.


RESULTS
Eight trials were identified, comprising 20,997 patients. In patients with prior myocardial infarction (MI), omega-3 fatty acids reduced relative risk (RR) of SCD (RR = 0.43; 95% CI: 0.20-0.91). In patients with angina, omega-3 fatty acids increased RR of SCD (RR = 1.39; 95% CI: 1.01-1.92). Overall, RR for cardiac death and all-cause mortality were 0.71 (95% CI: 0.50-1.00) and 0.77 (95% CI: 0.58-1.01), respectively.


CONCLUSIONS
Dietary supplementation with omega-3 fatty acids reduces the incidence of sudden cardiac death in patients with MI, but may have adverse effects in angina patients.
Zhao
Yun-Tao
YT
Department of Cardiology, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, China.
Chen
Qiang
Q
Sun
Ya-Xun
YX
Li
Xue-Bin
XB
Zhang
Ping
P
Xu
Yuan
Y
Guo
Ji-Hong
JH
D000787:Angina Pectoris / Q000178:diet therapy; D003327:Coronary Disease / Q000150:complications / Q000401:mortality; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000178:diet therapy; D016032:Randomized Controlled Trials as Topic
D015525:Fatty Acids, Omega-3