Dietary omega-3 fatty acids levels not tied to increased risk of atrial fibrillation: JACC

A meta-analysis of a global consortium of 17 prospective cohort studies found no relation between levels of omega-3 fatty acids, (including DHA, DPA, EPA, and EPA+DHA) primarily from diet and risk for incident atrial fibrillation.

"Coupled with the known benefits of these fatty acids for preventing adverse coronary events, our study suggests that current dietary guidelines recommending fish/omega-3 fatty acid consumption can be maintained," the researchers wrote.

Frank Qian, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA, and colleagues sought to determine the prospective associations of blood or adipose tissue levels of docosapentaenoic acid (DPA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) with incident atrial fibrillation.

For this purpose, the researchers used participant-level data from a global consortium of 17 prospective cohort studies, each with baseline data on adipose or blood tissue omega-3 fatty acid levels and AF outcomes. Each participating study conducted a de novo analysis using a prespecified analytical plan with harmonized definitions for outcomes, exposures, subgroups, and covariates. Associations were pooled using inverse-variance weighted meta-analysis.

The authors reported the following findings:

• Among 54,799 participants from 17 cohorts, 7,720 incident cases of AF were ascertained after a median of 13.3 years of follow-up.
• In multivariable analysis, EPA levels were not associated with incident AF, and HR per interquintile range (ie, the difference between the 90th and 10th percentiles) was 1.00.
• HRs for higher levels of DPA, DHA, and EPA+DHA, were 0.89, 0.90, and 0.93, respectively.
• The results were similar in patients at elevated CV risk and did not vary by age, sex or region.

The findings are in contrast with the results of trials of omega-3 fatty acid supplementation, which found omega-3 fatty acid supplementation was associated with an increased AF risk.

"Based on present evidence, moderate dietary intake of seafood and fish is unlikely to achieve sufficiently high omega-3 fatty acid levels in tissue or blood that would result in an increased risk of atrial fibrillation as observed in clinical trials of fish oil supplements and high-dose prescriptions of EPA and EPA + DHA," Christie M. Ballantyne, chief of the section of cardiovascular research and professor of medicine at Baylor College of Medicine, and Xiaoming Jia, MD, interventional cardiologist and assistant professor of medicine at Baylor College of Medicine, wrote in an accompanying editorial. "Therefore, fish should continue to be an important part of the menu of a heart-healthy diet.”

Reference:

The study titled, "Omega-3 Fatty Acid Biomarkers and Incident Atrial Fibrillation," was published in the Journal of the American College of Cardiology.

DOI: https://www.jacc.org/doi/10.1016/j.jacc.2023.05.024