Effect of high-dose marine omega-3 fatty acids on atherosclerosis: A systematic review and meta-analysis of randomized clinical trials

Akira Sekikawa, Chendi Cui, Daisuke Sugiyama, Anthony Fabio, William S. Harris, Xiao Zhang

Research output: Contribution to journalReview article

Abstract

A recent randomized controlled trial (RCT), the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT), reported that high-dose marine omega-3 fatty acids (OM3) significantly reduce cardiovascular disease (CVD) outcomes, yet the mechanisms responsible for this benefit remain unknown. To test the hypothesis that high-dose OM3 is anti-atherosclerotic, we performed a systematic review and meta-analysis of RCT of high-dose OM3 on atherosclerosis. The protocol of this systematic review was registered with PROSPERO (CRD42019125566). PubMed, Embase, Cochran Central Register for Controlled Trials, and Clinicaltrials.gov databases were searched using the following criteria: adult participants, high-dose OM3 (defined as ≥3.0 g/day, or in Japan 1.8 g/day and purity ≥90%) as the intervention, changes in atherosclerosis as the outcome, and RCTs with an intervention duration of ≥6 months. A random-effects meta-analysis was used to pool estimates across studies. Among the 598 articles retrieved, six articles met our criteria. Four RCTs evaluated atherosclerosis in the coronary and two in the carotid arteries. High-dose OM3 significantly slowed the progression of atherosclerosis (standardized mean difference −1.97, 95% confidence interval −3.01, −0.94, p < 0.001). The results indicate that anti-atherosclerotic effect of high-dose OM3 is one potential mechanism in reducing CVD outcomes demonstrated in the REDUCE-IT trial.

Original languageEnglish
Article number2599
JournalNutrients
Volume11
Issue number11
DOIs
Publication statusPublished - 2019 Nov

Fingerprint

randomized clinical trials
Omega-3 Fatty Acids
systematic review
atherosclerosis
meta-analysis
omega-3 fatty acids
Meta-Analysis
Atherosclerosis
Randomized Controlled Trials
Cardiovascular Diseases
dosage
Carotid Arteries
PubMed
cardiovascular diseases
Coronary Artery Disease
Japan
Databases
Confidence Intervals
carotid arteries
purity

Keywords

  • Atherosclerosis
  • High-dose
  • Marine omega-3 fatty acids
  • Mechanism
  • Meta-analysis
  • Randomized clinical trial
  • Systematic review

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

Cite this

Effect of high-dose marine omega-3 fatty acids on atherosclerosis : A systematic review and meta-analysis of randomized clinical trials. / Sekikawa, Akira; Cui, Chendi; Sugiyama, Daisuke; Fabio, Anthony; Harris, William S.; Zhang, Xiao.

In: Nutrients, Vol. 11, No. 11, 2599, 11.2019.

Research output: Contribution to journalReview article

Sekikawa, Akira ; Cui, Chendi ; Sugiyama, Daisuke ; Fabio, Anthony ; Harris, William S. ; Zhang, Xiao. / Effect of high-dose marine omega-3 fatty acids on atherosclerosis : A systematic review and meta-analysis of randomized clinical trials. In: Nutrients. 2019 ; Vol. 11, No. 11.
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abstract = "A recent randomized controlled trial (RCT), the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT), reported that high-dose marine omega-3 fatty acids (OM3) significantly reduce cardiovascular disease (CVD) outcomes, yet the mechanisms responsible for this benefit remain unknown. To test the hypothesis that high-dose OM3 is anti-atherosclerotic, we performed a systematic review and meta-analysis of RCT of high-dose OM3 on atherosclerosis. The protocol of this systematic review was registered with PROSPERO (CRD42019125566). PubMed, Embase, Cochran Central Register for Controlled Trials, and Clinicaltrials.gov databases were searched using the following criteria: adult participants, high-dose OM3 (defined as ≥3.0 g/day, or in Japan 1.8 g/day and purity ≥90{\%}) as the intervention, changes in atherosclerosis as the outcome, and RCTs with an intervention duration of ≥6 months. A random-effects meta-analysis was used to pool estimates across studies. Among the 598 articles retrieved, six articles met our criteria. Four RCTs evaluated atherosclerosis in the coronary and two in the carotid arteries. High-dose OM3 significantly slowed the progression of atherosclerosis (standardized mean difference −1.97, 95{\%} confidence interval −3.01, −0.94, p < 0.001). The results indicate that anti-atherosclerotic effect of high-dose OM3 is one potential mechanism in reducing CVD outcomes demonstrated in the REDUCE-IT trial.",
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