Background: n-3 Polyunsaturated fatty acids (n-3 PUFAs) have been proposed as prophylactic therapy in the prevention of postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery. We conducted a meta-analysis of randomized controlled trials to better clarify this issue. Methods: An electronic database search for randomized controlled trials on the effect of n-3 PUFAS on POAF was conducted, limited to English language publications until December 2010. For each study, data regarding the incidence of POAF were used to generate risk ratio (<1, favors n-3 PUFA; >1, favors placebo). Pooled summary effect estimate was calculated by means of a fixed or random effect according to heterogeneity. Meta-regression was used to investigate the effect of eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) ratio and preoperative β-blockers on the effect of n-3 PUFA on POAF. Results: Three publications were included in the analysis, enrolling a total of 431 patients. Overall incidence of POAF ranged from 24 to 54%. Pooling data, n-3 PUFA did not show a significant effect on the risk of POAF [risk ratio 0.89; 95% confidence interval (CI) 0.55–1.44; P = 0.63]. However, meta-regression analysis showed a trend toward a benefit from n-3 PUFA supplementation when the EPA/DHA ratio was 1:2 (Q model = 7.4; p model = 0.02) and when preoperative β-blocker rate was lower (Q model = 8.0; p model = 0.01). Conclusion: In conclusion, the results of the present meta-analysis of randomized controlled trials suggest that preoperative n-3 PUFA therapy may not reduce POAF in patients undergoing cardiac surgery. However, several aspects may have influenced this negative result, which need to be investigated.

n-3 Polyunsaturated fatty acids for the prevention of postoperative atrial fibrillation: a meta-analysis of randomized controlled trials / Benedetto, Umberto; Angeloni, Emiliano; Melina, G; Danesi, Th; DI BARTOLOMEO, Roberta; Lechiancole, A; Refice, Simone; Roscitano, A; Comito, Cosimo; Sinatra, Riccardo. - In: JOURNAL OF CARDIOVASCULAR MEDICINE. - ISSN 1558-2027. - STAMPA. - 14:(2011), pp. 104-109. [10.2459/JCM.0b013e32834a13c1]

n-3 Polyunsaturated fatty acids for the prevention of postoperative atrial fibrillation: a meta-analysis of randomized controlled trials.

BENEDETTO, UMBERTO;ANGELONI, EMILIANO;Melina G;DI BARTOLOMEO, ROBERTA;REFICE, SIMONE;COMITO, Cosimo;SINATRA, Riccardo
2011

Abstract

Background: n-3 Polyunsaturated fatty acids (n-3 PUFAs) have been proposed as prophylactic therapy in the prevention of postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery. We conducted a meta-analysis of randomized controlled trials to better clarify this issue. Methods: An electronic database search for randomized controlled trials on the effect of n-3 PUFAS on POAF was conducted, limited to English language publications until December 2010. For each study, data regarding the incidence of POAF were used to generate risk ratio (<1, favors n-3 PUFA; >1, favors placebo). Pooled summary effect estimate was calculated by means of a fixed or random effect according to heterogeneity. Meta-regression was used to investigate the effect of eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) ratio and preoperative β-blockers on the effect of n-3 PUFA on POAF. Results: Three publications were included in the analysis, enrolling a total of 431 patients. Overall incidence of POAF ranged from 24 to 54%. Pooling data, n-3 PUFA did not show a significant effect on the risk of POAF [risk ratio 0.89; 95% confidence interval (CI) 0.55–1.44; P = 0.63]. However, meta-regression analysis showed a trend toward a benefit from n-3 PUFA supplementation when the EPA/DHA ratio was 1:2 (Q model = 7.4; p model = 0.02) and when preoperative β-blocker rate was lower (Q model = 8.0; p model = 0.01). Conclusion: In conclusion, the results of the present meta-analysis of randomized controlled trials suggest that preoperative n-3 PUFA therapy may not reduce POAF in patients undergoing cardiac surgery. However, several aspects may have influenced this negative result, which need to be investigated.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/481472
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