Omega-3 fatty acids supplementation: increased risk of atrial fibrillation

Abstract

Omega-3 fatty acids (O3FA) supplementation is associated with an increased risk of atrial fibrillation (AF) in patients with elevated plasma triglyceride levels and at high risk of cardiovascular disease (CVD). This is the main finding of an updated meta-analysis of randomised controlled trials (RCTs) that investigated whether O3FA supplementation is associated with an increased risk of AF, compared with placebo. Poisson regression with a random effects model was used to conduct a pairwise meta-analysis. A systematic search identified 5 RCTs that were included in the meta-analysis: REDUCE IT, ASCEND, R&P, STRENGTH and OMEMI. Both fixed-effect and random-effect models showed that O3FA supplementation was associated with a significantly increased risk of incident AF, as compared with placebo (incidence rate ratio [IRR] 1.37). Inclusion of data from the VITAL rhythm trial confirmed a significantly higher risk of AF among patients receiving O3FA supplementation, as compared with placebo (IRR 1.29). This finding is concerning given the large proportion of patients eligible for treatment with O3FA supplementation, note the researchers. The analysis also showed that there was no statistically significant heterogeneity across studies, and there was no publication bias. The researchers conclude that the risk of AF should be considered when prescribing O3FA supplementation in this population.