Omega-3 fatty acids for postoperative atrial fibrillation: alone or in combination with antioxidant vitamins?

Abstract

BACKGROUND:

The effects of omega-3 polyunsaturated fatty acids (PUFA) on the prevention of postoperative atrial fibrillation (POAF) are inconclusive in current studies. Moreover, the most appropriate composition of PUFA to play the protective role is unclear. The aim of this meta-analysis was to ascertain the protective role of PUFA on POAF and the most appropriate composition.

METHODS:

Studies were identified through PubMed, CENTRAL, EMBASE, reviews and reference lists of relevant papers. The odds ratio (OR) was calculated for POAF. Statistical analyses were performed with Review Manager 5.0.

RESULTS:

Eleven randomised controlled trials with 3137 patients were included in the analysis. The use of PUFA alone did not reduce the incidence of POAF compared with the control (OR: 0.76; 95% confidence interval [CI]: 0.57-1.03; P=0.08; I(2)=52%). However, combination therapy with PUFA and vitamins C and E reduced the incidence of POAF by 68% (OR: 0.32; 95%CI: 0.17-0.60; P=0.0005; I(2)=38%). Subgroup analysis indicated that the ratio of EPA/DHA 1:2 was effective in preventing POAF (OR: 0.35; 95%CI: 0.24-0.50; P<0.00001; I(2)=0%), while the ratio not 1:2 failed.

CONCLUSIONS:

Combination therapy with PUFA and vitamins C and E is effective in the prevention of POAF while PUFA alone is not. The ratio of EPA/DHA may influence the incidence of POAF, and 1:2 may be most appropriate. Studies about PUFA on the prevention of POAF are still worthwhile to be conducted in the future.

• Authors: Xue-Yuan Guo, Xian-Liang Yan, Ying-Wei Chen, Ri-Bo Tang, Xin Du, Jian-Zeng Dong, Chang-Sheng Ma
• Journal: Heart, lung & circulation (Heart Lung Circ) Vol. 23 Issue 8 Pg. 743-50 (Aug 2014) ISSN: 1444-2892 [Electronic] Australia
• PMID: 24685324 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)
• Copyright: Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Chemical References

• Antioxidants
• Fatty Acids, Omega-3
• Vitamins
• Vitamin E
• Ascorbic Acid

Topics

• Antioxidants (therapeutic use)
• Ascorbic Acid (therapeutic use)
• Atrial Fibrillation (prevention & control)
• Cardiac Surgical Procedures (adverse effects)
• Fatty Acids, Omega-3 (therapeutic use)
• Female
• Humans
• Male
• Postoperative Complications (prevention & control)
• PubMed
• Randomized Controlled Trials as Topic
• Vitamin E (therapeutic use)
• Vitamins (therapeutic use)