Fish consumption, omega-3 fatty acids and risk of heart failure: A meta-analysis

Background & aims: While marine omega-3 fatty acids have been associated with a lower mortality in heart failure patients,. data on omega-3 and incident heart failure are inconsistent. We systematically reviewed the evidence on the association of omega-3 fatty acids and fish intake with the incidence of heart failure in this meta-analysis. Methods: We identified relevant studies by searching MEDLINE and EMBASE databases up to August 31, 2011 without restrictions and by reviewing reference lists from retrieved articles. Results: A total of 176,441 subjects and 5480 incident cases of heart failure from 7 prospective studies were included in this analysis. Using random effect model, the pooled relative risk for heart failure comparing the highest to lowest category of fish intake was 0.85 (95% CI; 0.73-0.99), p = 0.04; corresponding value for marine omega-3 fatty acids was 0.86 (0.74-1.00), p = 0.05. There was no evidence for heterogeneity across studies of fish consumption (I-2 = 8%). In contrast, there was modest heterogeneity for omega-3 fatty acid analysis (I-2 = 44%). Lastly, there was no evidence for publication bias. Conclusions: This meta-analysis is consistent with a lower risk of heart failure with intake of marine omega-3 fatty acids. These observational findings should be confirmed in a large randomized trial. (C) 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.