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.