Arya Sukumar, College of Agriculture, Vellayani
A comprehensive review on the role of omega-3 Fatty acids in cardiovascular protection was conducted by Investigators from Brigham and Women’s Hospital. The meta-analysis, which is an in-depth assessment of several clinical studies, gives authoritative evidence for increasing omega-3 fatty acid consumption, such as EPA and DHA. Omega-3 fatty acids have been shown to enhance outcomes and lower cardiovascular mortality in studies. With EPA monotherapy, the reduction in cardiovascular risk was higher than with EPA+DHA.
What are EPA and DHA omega-3 Fatty acids?
Long-chain Omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are obtained from marine sources. Eating fish, especially fatty fish like salmon, anchovies and sardines, is the best method to acquire EPA and DHA omega-3 FAs. The biological effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on cell membrane structure and lipid metabolism are different.
As a result, combining DHA and EPA may alter the therapeutic outcomes of EPA therapy. EPA and DHA have been shown to reduce the risk of atherosclerotic cardiovascular disease (ASCVD) events through a variety of mechanisms, including lowering TG, membrane stabilisation, and antithrombotic, anti-inflammatory, and antiarrhythmic properties. Previous studies have connected EPA and DHA omega-3 fatty acid consumption to a lower risk of coronary heart disease (CHD), which kills 7.4 million people worldwide each year, and myocardial infarction (heart attack), which includes fatal heart attacks. Since most individuals consume far less fish than is advised, supplementing with omega-3 FAs can help bridge the gap.
Previous meta-analyses combined the EPA and EPA+DHA studies, potentially masking the effects of individual omega-3 fatty acid formulations (FAs). The current study investigates the effects of omega-3 fatty acids on fatal and non-fatal cardiovascular events, as well as the therapeutic effects of EPA and EPA+DHA. They looked at 38 randomised controlled studies of omega-3 fatty acids that were split into two groups: EPA monotherapy and EPA+DHA therapy. The major outcomes investigated were cardiovascular death, nonfatal cardiovascular events, haemorrhage, and atrial fibrillation (AF).
This study backs up the findings of a previous meta-analysis of many clinical trials. In 2009, the JELIS (Japan EPA Lipid Intervention Study) study found that utilising purified EPA reduced major coronary events in individuals with hypercholesterolemia. In 2018, three randomised controlled studies investigating various omega-3 FA preparations, notably ASCEND, VITAL, and REDUCE-IT yielded divergent results. The major cardiovascular endpoints of the ASCEND (A Study of Cardiovascular Events in Diabetes) and VITAL (Vitamin D and Omega-3 Trial) studies utilising EPA+DHA were not significantly reduced while, the REDUCE-IT trial discovered that icosapent ethyl, a highly purified ethyl ester of EPA, significantly reduced the primary composite efficacy endpoint of cardiovascular death or unstable angina in patients with ASCVD (diabetes with at least one additional risk factor) or those at high risk for ASCVD. A major endpoint, cardiovascular mortality, MI, or stroke was decreased by 26%, while death from cardiovascular causes was reduced by 20%. Because of the conflicting trial findings, there is a lot of confusion and controversy concerning the function of omega-3 fatty acids in decreasing ASCVD residual risk.
A systematic review and meta-analysis with a major focus on assessing the effectiveness and safety of omega-3 FAs on fatal and non-fatal cardiovascular events in adults were conducted to investigate the clinical heterogeneity among omega-3 FAs studies. The goal was to see if there was any variation in the effects caused by EPA vs. EPA+DHA therapy. This meta-analysis reaffirms the importance of omega-3 fatty acids, particularly EPA. This study will entice researchers to look into the cardiovascular effects of EPA in a variety of clinical situations.
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REFERENCE:
- Khan, S. U., Lone, A. N., Khan, M. S., Virani, S. S., Blumenthal, R. S., Nasir, K., Miller, M., Michos, E. D., Ballantyne, C. M., Boden, W. E., & Bhatt, D. L. (2021). Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis. EClinicalMedicine, 100997. https://doi.org/10.1016/j.eclinm.2021.100997
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