The use of ω-3 poly-unsaturated fatty acids in heart failure: a preferential role in patients with diabetes.
OBJECTIVE
To review the evidence for a beneficial effect of ω-3 PUFAs in heart failure (HF) and its co-morbidities, their possible preferential effect in diabetes and the potential mechanism for their benefit.


METHODS
We summarize the clinical studies which investigated the use of ω-3 PUFAs in patients with HF with an emphasis on diabetes. We briefly summarize the evidence for an effect of ω-3 PUFAs in patients with coronary artery disease (CAD), atrial fibrillation (AF) and ventricular arrhythmias. We also discuss the proposed mechanisms of ω-3 PUFA action in cardiovascular diseases.


RESULTS
While there is emerging evidence for a beneficial effect of ω-3 PUFA supplementation in patients with HF, the evidence for other indications have been variable and conflicting. In HF patients with diabetes, ω-3 PUFAs may have a preferential therapeutic benefit. Randomized controlled trials did not show considerable beneficial effects of ω-3 PUFAs in other conditions such as CAD and AF. In a diabetic and insulin-resistant state, ω-3 PUFAs bind to the G-protein coupled receptor, GPR120, resulting in reduced cytokine production from inflammatory macrophages and improved signaling in adipocytes, leading to a reduction in insulin resistance.


CONCLUSIONS
There is promising evidence showing that use of ω-3 PUFA supplementation improves clinical outcomes of HF patients with diabetes. Further clinical trials are needed in this regard.
Division of Cardiology, Department of Medicine, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada.
Pedram
P
Kazemian
Seyyed M R
SM
Kazemi-Bajestani
Aws
A
Alherbish
Justin
J
Steed
Gavin Y
GY
Oudit
D048909:Diabetes Complications / Q000188:drug therapy*; D003920:Diabetes Mellitus / Q000188:drug therapy*; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology*; D005231:Fatty Acids, Unsaturated / Q000494:pharmacology*; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic
D015525:Fatty Acids, Omega-3; D005231:Fatty Acids, Unsaturated