Omega-3 Fatty Acid Biomarkers and Incident Atrial Fibrillation.
Level 3 - non-randomized controlled study
Pooled individual participant-level meta-analysis of prospective observational cohort studies
PubMed 37468189 · doi:10.1016/j.jacc.2023.05.024
What was done
Researchers pooled participant-level data from a global consortium of 17 prospective cohort studies to evaluate the relationship between baseline blood or adipose tissue biomarkers of omega-3 fatty acids (EPA, DPA, and DHA) and incident atrial fibrillation (AF). Cohorts performed de novo analyses using a prespecified, harmonized analytical protocol for exposures, covariates, and outcomes, with results combined using inverse-variance weighted meta-analysis over a median follow-up of 13.3 years.
What was found
Across 54,799 participants and 7,720 incident AF cases, multivariable-adjusted hazard ratios (HR) per interquintile range (90th vs. 10th percentile) showed no increased risk for any biomarker. EPA was not associated with incident AF (HR 1.00, 95% CI: 0.95–1.05). Higher levels of other fatty acids showed modest inverse associations: DPA HR was 0.89 (95% CI: 0.83–0.95), DHA HR was 0.90 (95% CI: 0.85–0.96), and combined EPA+DHA HR was 0.93 (95% CI: 0.87–0.99).
Why it matters
Recent randomized trials of high-dose prescription omega-3 supplements reported an elevated risk of atrial fibrillation. These findings indicate that habitual dietary levels and circulating biomarkers of omega-3s are safe regarding AF risk and support maintaining standard dietary recommendations for fish and omega-3 consumption.
Limits
As an observational analysis, these findings reflect physiological and dietary biomarker levels rather than high-dose pharmaceutical supplementation, and residual confounding cannot be fully excluded. Omega-3 levels were measured only at baseline, potentially failing to capture dietary changes across the 13.3-year median follow-up.
Cited by
- supports Two cohort studies following participants over time have found that higher baseline omega-3 levels are associated with a lower risk of developing atrial fibrillation.