Fish consumption, omega-3 fatty acids and risk of heart failure: A meta-analysis

SummaryBackground & aimsWhile marine omega-3 fatty acids have been associated with a lower mortality in heart failure patients, data on omega-3 and incident heart failure are inconsistent. We systematically reviewed the evidence on the association of omega-3 fatty acids and fish intake with the incidence of heart failure in this meta-analysis.MethodsWe identified relevant studies by searching MEDLINE and EMBASE databases up to August 31, 2011 without restrictions and by reviewing reference lists from retrieved articles.ResultsA total of 176,441 subjects and 5480 incident cases of heart failure from 7 prospective studies were included in this analysis. Using random effect model, the pooled relative risk for heart failure comparing the highest to lowest category of fish intake was 0.85 (95% CI; 0.73–0.99), p = 0.04; corresponding value for marine omega-3 fatty acids was 0.86 (0.74–1.00), p = 0.05. There was no evidence for heterogeneity across studies of fish consumption (I2 = 8%). In contrast, there was modest heterogeneity for omega-3 fatty acid analysis (I2 = 44%). Lastly, there was no evidence for publication bias.ConclusionsThis meta-analysis is consistent with a lower risk of heart failure with intake of marine omega-3 fatty acids. These observational findings should be confirmed in a large randomized trial.