ARS | Publication request: Effects of Omega-3 Fatty Acids on Coronary Restenosis, Intima-Media Thickness, Exercise Tolerance and Heart Rate Variability: a Systematic Review

Submitted to: Atherosclerosis
Publication Type: Review Article
Publication Acceptance Date: June 7, 2005
Publication Date: February 1, 2006
Reprint URL: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16084516&query_hl=14&itool=pubmed_docsum
Citation: Balk, E.M., Lichtenstein, A.H., Chung, M., Kupelnick, B., Chew, P., Lau, J. 2006. Effects of omega-3 fatty acids on coronary restenosis, intima-media thickness, exercise tolerance and heart rate variability: a systematic review. Atherosclerosis. 184(2):237-46.

Technical Abstract: We conducted a systematic review of omega-3 fatty acids and measures of coronary artery restenosis, carotid intima-media thickness, exercise tolerance and heart rate variability. The mechanisms by which fish or omega-3 fatty acids reduce cardiovascular disease risks are unclear, but may involve lesion formation and heart function. Included are studies that assessed the effect of dietary omega-3 fatty acid (fish, fish oils or plant oils) on coronary artery restenosis, carotid intima-media thickness, exercise tolerance and heart rate variability. Excluded were studies that used supplements of more than 6 g per day or less than 4 weeks duration. Compared to placebo, the summary risk ratio of coronary artery restenosis with fish oils was 0.86 (95% confidence interval 0.71, 1.03) across 12 studies. Two prospective studies reported increased carotid intima-media thickness, whereas 2 cross-sectional studies reported decreased intima-media thickness, associated with fish, fish oil or plant oil consumption. Three randomized trials and 3 uncontrolled cohort studies reported small non-significant improvements in exercise capacity with fish oils. In 2 studies, heart rate variability was unaffected by dietary fish or fish oil supplementation in healthy subjects, but showed a small non-significant improvement in patients with recent myocardial infarctions. Little or no effect of omega-3 fatty acids was found for a variety of markers of cardiovascular disease risk. Heterogeneity of treatment regime and characteristics of study population was common. The dearth of long term data on fish or omega-3 fatty acid supplementation on measures of cardiovascular disease severely limits the development of evidence-based recommendations at this time.