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Fish-oil supplementation in patients with implantable cardioverter defibrillators: a meta-analysis
- Publication Year :
- 2008
- Publisher :
- Canadian Medical Association, 2008.
-
Abstract
- Background: A recent Cochrane meta-analysis did not confirm the benefits of fish and fish oil in the secondary prevention of cardiac death and myocardial infarction. We performed a meta-analysis of randomized controlled trials that examined the effect of fish-oil supplementation on ventricular fibrillation and ventricular tachycardia to determine the overall effect and to assess whether heterogeneity exists between trials. Methods: We searched electronic databases (MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials, CINAHL) from inception to May 2007. We included randomized controlled trials of fish-oil supplementation on ventricular fibrillation or ventricular tachycardia in patients with implantable cardioverter defibrillators. The primary outcome was implantable cardioverter defibrillator discharge. We calculated relative risk [RR] for outcomes at 1-year follow-up for each study. We used the DerSimonian and Laird random-effects methods when there was significant heterogeneity between trials and the Mantel-Hanzel fixed-effects method when heterogeneity was negligible. Results: We identified 3 trials of 1–2 years' duration. These trials included a total of 573 patients who received fish oil and 575 patients who received a control. Meta-analysis of data collected at 1 year showed no overall effect of fish oil on the relative risk of implantable cardioverter defibrillator discharge. There was significant heterogeneity between trials. The second largest study showed a significant benefit of fish oil (relative risk [RR] 0.74, 95% confidence interval [CI] 0.56–0.98). The smallest showed an adverse tendency at 1 year (RR 1.23, 95% CI 0.92–1.65) and significantly worse outcome at 2 years among patients with ventricular tachycardia at study entry (log rank p = 0.007). Conclusion: These data indicate that there is heterogeneity in the response of patients to fish-oil supplementation. Caution should be used when prescribing fish-oil supplementation for patients with ventricular tachycardia.
- Subjects :
- Tachycardia
Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Myocardial Infarction
Ventricular tachycardia
Risk Assessment
Drug Administration Schedule
law.invention
Fish Oils
Randomized controlled trial
law
Reference Values
Internal medicine
Fatty Acids, Omega-3
medicine
Animals
Humans
Myocardial infarction
Survival rate
Aged
Randomized Controlled Trials as Topic
Dose-Response Relationship, Drug
business.industry
Research
General Medicine
Middle Aged
medicine.disease
Implantable cardioverter-defibrillator
Survival Analysis
Defibrillators, Implantable
Death
Survival Rate
Primary Prevention
Treatment Outcome
Cardiovascular Diseases
Relative risk
Ventricular fibrillation
Dietary Supplements
Cardiology
Tachycardia, Ventricular
Commentary
Female
medicine.symptom
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....8f81115d5ed21fb9b9c90e9ff3c2b63a