The Role of Omega-3 Polyunsaturated Fatty Acids in Heart Failure: A Meta-Analysis of Randomised Controlled Trials.

Key Findings

This meta-analysis was undertaken to assess the benefits of omega-3 PUFAs in heart failure (HF) patients, and included new outcomes, such as brain natriuretic peptide (BNP), and serum norepinephrine (SNE) levels, Tei index, and peak oxygen consumption (peak VO₂) for analysis. Nine studies were eligible for the meta-analysis. The dose of omega-3 PUFAs (calculated as the total dose of ALA, EPA, and DHA) ranged from 1 g/day to 4 g/day, with the ratio of EPA to DHA varying from 0.60 g/day to 1.53 g/day. The duration of the investigation varied from 3 to 12 months. Omega-3 PUFAs did not improve the LVEF and other clinical outcomes (Tei index, peak VO₂) in patients with HF overall. Data showed that omega-3 PUFAs could decrease BNP and NT-proBNP levels. Plasma BNP or NT-proBNP concentration is an indicator of the severity of HF and increases exponentially as the cardiac condition worsens. The meta-analysis showed that omega-3 PUFAs could significantly decrease SNE levels which would improve cardiac function and remodelling. These findings suggest that omega-3 PUFAs might be beneficial to HF patients, but the evidence is not definitive.

ABSTRACT

Many new clinical trials about the effect of omega-3 polyunsaturated fatty acids (PUFAs) in heart failure (HF) patients have shown inconsistent results. Therefore, a meta-analysis of randomised controlled trials (RCTs) was performed to determine the benefits of omega-3 PUFAs in HF patients. Articles were obtained from PubMed, EMBASE, and the Cochrane Library. RCTs comparing omega-3 PUFAs with placebo for HF were included. Two reviewers independently extracted the data from the selected publications. The I² statistic was used to assess heterogeneity. The pooled mean difference and associated 95% confidence intervals were calculated, and a fixed or random-effects model was used for the meta-analysis. A total of nine RCTs involving 800 patients were eligible for inclusion. Compared with patients taking placebo, HF patients who received omega-3 PUFAs experienced decreased brain natriuretic peptide levels and serum norepinephrine levels. Although the left ventricular ejection fraction (LVEF) and clinical outcomes (Tei index, peak oxygen consumption) did not improve, subgroup analysis showed that the LVEF increased in dilated cardiomyopathy (DCM) patients. Overall, omega-3 PUFA supplements might be beneficial in HF patients, especially in DCM patients, but further studies are needed to confirm these benefits.