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Omega-3 for the prevention of cardiovascular diseases: meta-analysis and trial-sequential analysis
  1. Maria Francesca Cabiddu1,
  2. Alberto Russi2,
  3. Lucia Appolloni3,
  4. Daniele Mengato4,
  5. Marco Chiumente5
  1. 1School of Hospital Pharmacy, University of Florence Faculty of Pharmacy, Firenze, Toscana, Italy
  2. 2School of Hospital Pharmacy, University of Padua Department of Pharmaceutical and Pharmacological Sciences, Padova, Italy
  3. 3Farmacia Clinica, Policlinico S.Orsola-Malpighi, Bologna, Italy
  4. 4Department of Hospital Pharmacy, Bolzano Hospital, Bolzano, Trentino-Alto Adige, Italy
  5. 5Scientific Direction, Italian Society for Clinical Pharmacy, Milan, Italy
  1. Correspondence to Alberto Russi, School of Hospital Pharmacy, University of Padua Department of Pharmaceutical and Pharmacological Sciences, Padova 35122, Italy; albertorussi90{at}


Objectives The effectiveness of omega-3 fatty acids (PUFAs) in cardiovascular diseases (CVD) remains a matter of debate. The aim of this work was to evaluate PUFAs in the reduction of cardiovascular mortality in primary and secondary prevention of CVD to determine if further original studies are needed or the available data can be considered conclusive.

Methods A meta-analysis was performed according to a dichotomous endpoint followed by a trial-sequential analysis (TSA). Clinical data were identified through a PubMed search based on the following keywords: omega-3 fatty acids; cardiovascular disease; death; and cardiovascular risk. The clinical trials identified by this procedure were subjected to standard meta-analysis and TSA.

Results and conclusions A total of 11 randomised studies for 100 609 patients were analysed. Our meta-analysis showed a statistically significant reduction in mortality due to cardiovascular issues (RR=0.937; 95% CI: 0.88 to 0.98; P=0.018). The TSA indicated that no further trials are needed to better evaluate the efficacy of PUFAs in preventing death related to CVD.

  • cardiac epidemiology
  • coronary heart disease
  • evidence-based medicine
  • nutrition & amp
  • dietetics
  • statistics & amp
  • research methods

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