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All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network Meta-Analysis from 55 Randomized Controlled Trials

Statins and omega-3 supplementation have shown potential benefits in preventing cardiovascular disease (CVD), but their comparative effects on mortality outcomes, in addition to primary and secondary prevention and mixed population, have not been investigated. This study aimed to examine the effect...

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Autores principales: Kim, Jeongseon, Hoang, Tung, Kim, Ji-Myung, Bu, So Young, Choi, Jeong-Hwa, Park, Eunju, Lee, Seung-Min, Park, Eunmi, Min, Ji Yeon, Lee, In Seok, Youn, So Young, Yeon, Jee-Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590109/
https://www.ncbi.nlm.nih.gov/pubmed/33092130
http://dx.doi.org/10.3390/nu12103203
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author Kim, Jeongseon
Hoang, Tung
Kim, Ji-Myung
Bu, So Young
Choi, Jeong-Hwa
Park, Eunju
Lee, Seung-Min
Park, Eunmi
Min, Ji Yeon
Lee, In Seok
Youn, So Young
Yeon, Jee-Young
author_facet Kim, Jeongseon
Hoang, Tung
Kim, Ji-Myung
Bu, So Young
Choi, Jeong-Hwa
Park, Eunju
Lee, Seung-Min
Park, Eunmi
Min, Ji Yeon
Lee, In Seok
Youn, So Young
Yeon, Jee-Young
author_sort Kim, Jeongseon
collection PubMed
description Statins and omega-3 supplementation have shown potential benefits in preventing cardiovascular disease (CVD), but their comparative effects on mortality outcomes, in addition to primary and secondary prevention and mixed population, have not been investigated. This study aimed to examine the effect of statins and omega-3 supplementation and indirectly compare the effects of statin use and omega-3 fatty acids on all-cause mortality and CVD death. We included randomized controlled trials (RCTs) from meta-analyses published until December 2019. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated to indirectly compare the effect of statin use versus omega-3 supplementation in a frequentist network meta-analysis. In total, 55 RCTs were included in the final analysis. Compared with placebo, statins were significantly associated with a decreased the risk of all-cause mortality (RR = 0.90, 95% CI = 0.86–0.94) and CVD death (RR = 0.86, 95% CI = 0.80–0.92), while omega-3 supplementation showed a borderline effect on all-cause mortality (RR = 0.97, 95% CI = 0.94–1.01) but were significantly associated with a reduced risk of CVD death (RR = 0.92, 95% CI = 0.87–0.98) in the meta-analysis. The network meta-analysis found that all-cause mortality was significantly different between statin use and omega-3 supplementation for overall population (RR = 0.91, 95% CI = 0.85–0.98), but borderline for primary prevention and mixed population and nonsignificant for secondary prevention. Furthermore, there were borderline differences between statin use and omega-3 supplementation in CVD death in the total population (RR = 0.92, 95% CI = 0.82–1.04) and primary prevention (RR = 0.85, 95% CI = 0.68–1.05), but nonsignificant differences in secondary prevention (RR = 0.97, 95% CI = 0.66–1.43) and mixed population (RR = 0.92, 95% CI = 0.75–1.14). To summarize, statin use might be associated with a lower risk of all-cause mortality than omega-3 supplementation. Future direct comparisons between statin use and omega-3 supplementation are required to confirm the findings.
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spelling pubmed-75901092020-10-29 All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network Meta-Analysis from 55 Randomized Controlled Trials Kim, Jeongseon Hoang, Tung Kim, Ji-Myung Bu, So Young Choi, Jeong-Hwa Park, Eunju Lee, Seung-Min Park, Eunmi Min, Ji Yeon Lee, In Seok Youn, So Young Yeon, Jee-Young Nutrients Article Statins and omega-3 supplementation have shown potential benefits in preventing cardiovascular disease (CVD), but their comparative effects on mortality outcomes, in addition to primary and secondary prevention and mixed population, have not been investigated. This study aimed to examine the effect of statins and omega-3 supplementation and indirectly compare the effects of statin use and omega-3 fatty acids on all-cause mortality and CVD death. We included randomized controlled trials (RCTs) from meta-analyses published until December 2019. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated to indirectly compare the effect of statin use versus omega-3 supplementation in a frequentist network meta-analysis. In total, 55 RCTs were included in the final analysis. Compared with placebo, statins were significantly associated with a decreased the risk of all-cause mortality (RR = 0.90, 95% CI = 0.86–0.94) and CVD death (RR = 0.86, 95% CI = 0.80–0.92), while omega-3 supplementation showed a borderline effect on all-cause mortality (RR = 0.97, 95% CI = 0.94–1.01) but were significantly associated with a reduced risk of CVD death (RR = 0.92, 95% CI = 0.87–0.98) in the meta-analysis. The network meta-analysis found that all-cause mortality was significantly different between statin use and omega-3 supplementation for overall population (RR = 0.91, 95% CI = 0.85–0.98), but borderline for primary prevention and mixed population and nonsignificant for secondary prevention. Furthermore, there were borderline differences between statin use and omega-3 supplementation in CVD death in the total population (RR = 0.92, 95% CI = 0.82–1.04) and primary prevention (RR = 0.85, 95% CI = 0.68–1.05), but nonsignificant differences in secondary prevention (RR = 0.97, 95% CI = 0.66–1.43) and mixed population (RR = 0.92, 95% CI = 0.75–1.14). To summarize, statin use might be associated with a lower risk of all-cause mortality than omega-3 supplementation. Future direct comparisons between statin use and omega-3 supplementation are required to confirm the findings. MDPI 2020-10-20 /pmc/articles/PMC7590109/ /pubmed/33092130 http://dx.doi.org/10.3390/nu12103203 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Jeongseon
Hoang, Tung
Kim, Ji-Myung
Bu, So Young
Choi, Jeong-Hwa
Park, Eunju
Lee, Seung-Min
Park, Eunmi
Min, Ji Yeon
Lee, In Seok
Youn, So Young
Yeon, Jee-Young
All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network Meta-Analysis from 55 Randomized Controlled Trials
title All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network Meta-Analysis from 55 Randomized Controlled Trials
title_full All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network Meta-Analysis from 55 Randomized Controlled Trials
title_fullStr All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network Meta-Analysis from 55 Randomized Controlled Trials
title_full_unstemmed All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network Meta-Analysis from 55 Randomized Controlled Trials
title_short All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network Meta-Analysis from 55 Randomized Controlled Trials
title_sort all-cause mortality and cardiovascular death between statins and omega-3 supplementation: a meta-analysis and network meta-analysis from 55 randomized controlled trials
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590109/
https://www.ncbi.nlm.nih.gov/pubmed/33092130
http://dx.doi.org/10.3390/nu12103203
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