Omega-3 fatty acids and malignant ventricular arrhythmias in patients with implantable cardioverter defibrillator
27th European Cardiology Conference
October 22-24, 2018 | Rome, Italy
Sabrina Zeghichi-Hamri, Patricia Salen, Michel de Lorgeril and Pascal Defaye
1Université de Béjaia. Faculté des Sciences de la Nature et de la Vie. Bejaia. Algeria.
2TIMC-IMAG CNRS 5525. Université Joseph Fourier.
3Service de Cardiologie. Hôpital Universitaire. Grenoble. France.
Studies that evaluated the effects of omega-3 polyunsaturated fatty acids (n-3) on cardiovascular diseases have yielded conflicting results. We aimed at examining the association between plant/marine n-3 and malignant ventricular arrhythmias (MVA) among patients benefiting from the best preventive strategy including implantable cardioverter defibrillator (ICD).
Consecutive patients in whom an ICD was implanted for primary or secondary prevention of MVA were eligible. All patients had blood fatty acid analysis. The method of Kaplan-Meier was used to estimate the survival curves in each quartile of the main plant (ALA) and marine (EPA and DHA) n-3.
Among the 238 enrolled patients, 100 had a relevant endpoint recorded by the ICD or died from a cardiac cause during a mean follow-up of 30±12 months. No significant difference in MVA was observed between quartiles of ALA (log-rank test p=0.88), EPA (log-rank test p=0.58) and DHA (log-rank test p=0.97). In a multivariate Cox proportional hazard model
including age, sex, ischemic heart disease, diabetes, smoking, hypertension and high cholesterol as covariates, we found no association between MVA and n-3: hazard ratio was 1.12 (95% CI 0.62-2.02) for ALA and 1.44 (95% CI 0.81-2.58) for the sum of main marine n-3.
Plant and marine n-3 do not seem to either increase or decrease the risk of MVA in patients who are not n-3 deficient and benefit from the most effective preventive treatment. Further studies are required to test whether n-3 deficient patients would still benefit from n-3 supplements. Finally, these data raise major questions regarding interactions between
dietary n-3 and certain medications.