Omega-3 Fatty Acid Supplementation and Coronary Heart Disease Risks: A Meta-Analysis of Randomized Controlled Clinical Trials

Meta-analysis of 14 randomized controlled trials in adults at high risk of coronary heart disease, with established CHD, or with acute myocardial infarction. Trials were conducted across multiple countries, including Italy, Japan, Germany, the Netherlands, France, the USA, the UK, Norway, and worldwide settings.

Omega-3 fatty acid supplementation was given orally, using EPA/DHA mixtures in most trials and EPA alone in some trials. Doses ranged from 0.40 to 3.60 g/day across included randomized studies, with treatment durations varying by trial; some comparisons used omega-3 FA versus control or placebo.

Omega-3 fatty acid supplementation modestly reduced major cardiovascular risk overall. Pooled effects showed lower MACE, cardiovascular death, and myocardial infarction, with RR 0.95 (0.91-0.99), RR 0.94 (0.89-0.99), and RR 0.86 (0.79-0.93), respectively. Effects were not significant for all-cause death, stroke, or revascularization overall. Subgroup analyses suggested benefit in acute MI, CHD, and high-risk populations, and a moderate dose of 0.8-1.2 g/day appeared most beneficial.

The evidence pools trials with different populations, formulations, and doses, which increases heterogeneity and limits direct comparability. Several major outcomes were null overall, and subgroup findings may be less robust than the main pooled estimates. Arm-level outcome reporting was not available, and baseline age or sex details were often not reported in the extracted trial summaries.