Omega-3 polyunsaturated fatty acids in cardiac surgery patients: An updated systematic review and meta-analysis

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#atrial-fibrillation #cardiac-surgical-procedures #dietary-supplements #dose-response-relationship-drug #fatty-acids-omega-3

Omega-3 polyunsaturated fatty acids in cardiac surgery patients: An updated systematic review and meta-analysis

Langlois et al., 2017 | Clin Nutr | Meta Analysis

Citation

Langlois Pascal L, Hardy Gil, Manzanares William. Omega-3 polyunsaturated fatty acids in cardiac surgery patients: An updated systematic review and meta-analysis. Clin Nutr. 2017-Jun;36(3):737-746. doi:10.1016/j.clnu.2016.05.013

Abstract

BACKGROUND: Omega-3 polyunsaturated fatty acids (ω-3 PUFA) supplementation is an attractive therapeutic option for patients undergoing open-heart surgery due to their anti-inflammatory and anti-arrhythmic properties. Several randomized controlled trials (RCT) have found contradictory results for perioperative ω-3 PUFA administration. Therefore, we conducted an updated systematic review and meta-analysis evaluating the effects of perioperative ω-3 PUFA on some clinically important outcomes for cardiac surgery. METHODS: A systematic literature search was conducted to find RCT evaluating clinical outcomes after ω-3 PUFA therapy in adult patients undergoing cardiac surgery. Intensive care unit (ICU) length of stay (LOS) was the primary outcome; secondary outcomes were hospital LOS, postoperative atrial fibrillation (POAF), mortality and duration of mechanical ventilation (MV). Predefined subgroup analysis and sensibility analysis were performed. RESULTS: A total of 19 RCT including 4335 patients met inclusion criteria. No effect of ω-3 PUFA on ICU LOS was found (weighted mean difference WMD -2.95, 95% confidence interval, CI -10.28 to 4.39, P = 0.43). However, ω-3 PUFA reduced hospital LOS (WMD -1.37, 95% CI -2.41 to -0.33; P = 0.010) and POAF incidence (Odds Ratio OR = 0.78, 95% CI 0.68 to 0.90; P = 0.004). No effects were found on mortality or MV duration. Heterogeneity remained in subgroup analysis and we found a significant POAF reduction when ω-3 PUFA doses were administered to patients exposed to extra-corporeal circulation. Oral/enteral administration seemed to further reduce POAF. CONCLUSIONS: In patients undergoing cardiac surgery, ω-3 PUFA supplementation by oral/enteral and parenteral route reduces hospital LOS and POAF. Nonetheless considerable clinical and statistical heterogeneity weaken our findings.

Key Findings

A total of 19 RCT including 4335 patients met inclusion criteria. No effect of ω-3 PUFA on ICU LOS was found (weighted mean difference WMD -2.95, 95% confidence interval, CI -10.28 to 4.39, P = 0.43). However, ω-3 PUFA reduced hospital LOS (WMD -1.37, 95% CI -2.41 to -0.33; P = 0.010) and POAF incidence (Odds Ratio OR = 0.78, 95% CI 0.68 to 0.90; P = 0.004). No effects were found on mortality or MV duration. Heterogeneity remained in subgroup analysis and we found a significant POAF reduction wh

Outcomes Measured

  • inflammatory markers

Population

Field Value
Population adult patients
Sample Size 4335
Age Range See abstract
Condition See abstract

MeSH Terms

  • Atrial Fibrillation
  • Cardiac Surgical Procedures
  • Dietary Supplements
  • Dose-Response Relationship, Drug
  • Fatty Acids, Omega-3
  • Humans
  • Incidence
  • Intensive Care Units
  • Length of Stay
  • Perioperative Care
  • Postoperative Period
  • Randomized Controlled Trials as Topic
  • Respiration, Artificial
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: omega-3

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09