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Objective To analyze the relationship between the proportion of omega-6/omega-3 and mortality in patients with cardiovascular disease (CVD), so as to provide reference for reducing the risk of death in patients with CVD. Methods The data of were collected from the UK perspective cohort (UK Biobank) database. The exposure variable was the proportion of plasma omega6/omega-3, and the outcomes were all- cause deaths, CVD deaths, ischemic heart disease (IHD) deaths, and stroke deaths. Multivariate Cox proportional hazard regression model was used to analyze the relationship between omega-6/ omega-3 ratio and death risk of CVD patients. Risk ratio hazard ratio (HR) and 95% confidence interval (CI) were calculated. Gender, age, and other risk factors were stratified and their interaction with omega-6/omega-3 ratio was analyzed. Restricted cubic spline (RCS) was used to describe the dose-response relationship. Sensitivity analysis was used to test the robustness of the model. Results A total of 35 096 participants were enrolled. Multivariate Cox proportional hazard regression model showed that all-cause deaths, CVD deaths, and ischemic heart disease deaths risk increased in CVD patients with the in¬crease of the proportion of omega-6/omega-3. For each unit increase in omega-6/omega-3 ratio, the risk of all-cause, CVD, and IHD deaths increased by 2.1% (HR=1.021, 95%CI: 1.016-0.025), 1.9% (HR=1.019, 95%CI: 1.010-1.028), and 2.3% (HR =1.023, 95% CI: 1.013-1.034), respectively. The proportion of omega-6/omega-3 was grouped according to quartile method and included in the model as a classified variable. Compared with Q1, the HR of all-cause, CVD, and IHD deaths of Q4 was 1.394 (95% CI: 1.267-1.534), 1.292 (95%CI: 1.085-1.540), and 1.528 (95% CI: 1.200-1.945), respectively, and no correlation was found between Q4 and stroke death risk (HR=0.987, 95%CI: 0.660-1.477). The results of RCS showed that the proportion of omega-6/omega3 was positively correlated with the risk of death. Conclusion The proportion of omega-6/ omega-3 is a risk factor for death in patients with CVD. [ABSTRACT FROM AUTHOR]

Aims A recent randomized placebo-controlled clinical trial has reported reductions in mortality and hospitalizations in patients with chronic heart failure (CHF) who were prescribed highly purified omega-3 polyunsaturated fatty acid ethyl esters (n-3 PUFA). This study aimed at evaluating the cost and benefits associated with their use in the treatment of CHF in a UK setting. Methods and results Results from a recent clinical trial were used to develop a Markov model to project clinical outcomes while capturing relevant costs and patient quality of life. The model captured outcomes over a lifetime horizon from a UK National Health Service perspective, with direct costs accounted in 2009 GBP (£) and discounted at 3.5% together with clinical benefits. Results are presented in terms of life expectancy, quality-adjusted life expectancy, direct costs, and incremental cost-effectiveness ratios. In addition to standard therapy, n-3 PUFA vs. placebo increased lifetime direct costs by £993 (≈€1150), with additional quality-adjusted life expectancy of 0.079 quality-adjusted life years (QALYs), and mean lifetime costs of £12 636 (≈€14 600) per QALY gained. Probabilistic sensitivity analyses suggested a 60% likelihood of n-3 PUFA being regarded as cost-effective versus placebo at a willingness-to-pay threshold of £30 000 (≈€34 600) per QALY gained. Conclusions By currently accepted standards of value for money in the UK; the addition of n-3 PUFA to optimal medical therapy for patients with heart failure is likely to be cost-effective. [ABSTRACT FROM AUTHOR]