TABLE 2—
Results From Major Randomized Placebo-Controlled Secondary Prevention Trials Examining the Effect of Fish or ω3-PUFA Intake on Various Cardiovascular Endpoints
| Results (All Adjusted) |
||
| Study and Outcomes | RR (95% CI) | P |
| DART31 | ||
| Total mortality | 0.71 (0.54, 0.93) | <.05 |
| CHD mortality | 0.67 (NA) | <.01 |
| Nonfatal MI | 1.48 (NA) | >.05 |
| CHD deaths + nonfatal MI | 0.84 (0.66, 1.07) | >.05 |
| Singh32 | ||
| Cardiac mortality | 0.52 (0.22, 1.21) | |
| Sudden death | 0.24 (0.03, 2.0) | |
| Nonfatal MI | 0.51 (0.23, 1.28) | |
| All cardiac events | 0.70 (0.29, 0.90) | |
| GISSI-Prevenzione33 | ||
| Total mortality | 0.86 (0.76, 0.98); 0.80 (0.67, 0.94)a | |
| CVD mortality | 0.83 (0.71, 0.97); 0.70 (0.56, 0.87)a | |
| Cardiac mortality | 0.78 (0.65, 0.92); 0.65 (0.51, 0.82)a | |
| CHD mortality | 0.80 (0.67, 0.96); 0.65 (0.51, 0.84)a | |
| Sudden cardiac death | 0.74 (0.58, 0.93); 0.55 (0.40, 0.76)a | |
| Stroke | 1.21 (0.91, 1.63); 1.30 (0.87, 1.96)a | |
| Nonfatal CV event | 0.98 (0.83, 1.15); 0.96 (0.76, 1.21)a | |
| CHD deaths + nonfatal MI | 0.87 (0.76, 0.99); 0.75 (0.62, 0.90)a | |
| Nilsen34 | ||
| Total mortality | 1.02 (0.44, 2.36) | |
| Cardiac mortality | 1.02 (0.38, 2.71) | |
| Nonfatal CV event | 1.30 (0.81, 2.08) | |
| DART-235 | ||
| Total mortality | 1.15 (0.96, 1.36)b | .13 |
| Cardiac mortality | 1.26 (1.00, 1.58)b | .047 |
| Sudden death | 1.54 (1.06, 2.23)b | .025 |
| JELIS26 | ||
| CHD mortality | 0.87 (0.46, 1.64) | .67 |
| Sudden cardiac death | 1.02 (0.47, 2.19) | .97 |
| Nonfatal MI | 0.70 (0.42, 1.14) | .15 |
| CHD death + nonfatal MI | 0.75 (0.47, 1.19) | .22 |
| Major coronary event | 0.81 (0.66, 1.00) | .048 |
| GISSI-HF36 | ||
| Total mortality | 0.91 (0.83, 0.998) | .041 |
| CVD mortality | 0.90 (0.81, 0.99) | .045 |
| Sudden cardiac death | 0.93 (0.79, 1.08) | .333 |
| Stroke | 1.16 (0.89, 1.51) | .271 |
| CHF admission | 0.94 (0.86, 1.02) | .147 |
| CHD deaths + nonfatal MI | 0.82 (0.63, 1.06) | .121 |
| OMEGA37 | ||
| Total mortality | 1.24 (NA) | .18 |
| Cardiac mortality | 1.29 (NA) | .16 |
| CHD event | 1.09 (NA) | .63 |
| Stroke | 2.00 (NA) | .07 |
| Sudden cardiac death | 0.98 (NA) | .84 |
| Total mortality + CHD event + stroke | 1.18 (NA) | .1 |
| α-OMEGA38 | ||
| Total mortality | 1.01 (0.82, 1.24) | .92 |
| CVD mortality | 0.98 (0.72, 1.33) | .89 |
| CHD mortality | 0.95 (0.68, 1.32) | .75 |
| Sudden cardiac death | 0.90 (0.65, 1.26) | .55 |
| CHD deaths + nonfatal MI | 1.01 (0.87, 1.17) | .93 |
Note. CHD = coronary heart disease; CHF = congestive heart failure; CI = confidence interval; CV = cardiovascular; CVD = cardiovascular disease; DART = Diet and Reinfarction Trial; GISSI = Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (Italian Group for the Study of Myocardial Infarction Survival) trial; HF = heart failure; JELIS = Japan EPA Intervention Lipid Study; MI = myocardial infarction; NA = not available; ω3-PUFA = ω3 polyunsaturated fatty acid; RR = relative risk.
a
2-way analysis; 4-way analysis.
b
2-way analysis of results for fish-intake groups.