Skip to main content
. 2019 Dec 21;12(1):35. doi: 10.3390/nu12010035

Table 2.

Poly-unsaturated fatty acids intake and mortality.

Author and Year of Publication Study Design Sample Size Risk of Mortality
GISSI Prevention trial, 1999, [93] Prospective Cohort Study 8496 cases and 2828 controls from a cohort of 11,324 subjects Death, non-fatal MI, and non-fatal stroke in two-way analysis:
RR = 0.90 (95% CI: 0.82–0.99, p = 0.048)
Cardiovascular death, non-fatal MI, and non-fatal stroke in two-way analysis:
RR = 0.89 (95% CI: 0.80–1.01, p = 0.053)
Death, non-fatal MI, and non-fatal stroke in four-way analysis:
RR = 0.85 (95% CI: 0.74–0.98, p = 0.023)
Cardiovascular death, non-fatal MI, and non-fatal stroke in four-way analysis:
RR = 0.80 (95% CI: 0.68–0.95, p = 0.008)
Yokoyama, 2007, [94] Prospective Randomised Open-Label Cohort Study 9326 EPA treatments and 9319 controls from a cohort of 18,645 subjects Incidence of coronary events in the total study population:
HR = 0.81 (95% CI: 0.69–0.95, p = 0.011) for EPA treatments vs. controls;
Incidence of coronary events in in the primary prevention arm:
HR = 0.82 (95% CI: 0.63–1.06, p = 0.132) for EPA treatments vs. controls;
Incidence of coronary events in in the secondary prevention arm:
HR = 0.81 (95% CI: 0.66–1.00, p = 0.048) for EPA treatments vs. controls
Kromhout, 2010, [95] Prospective Multi-centre, double-blind trial: n−3 fatty acids EPA and DHA and plant-derived ALA vs. placebo 1212 subjects randomized to receive EPA–DHA and ALA;
1192 subjects randomized to receive EPA–DHA and ALA placebo;
1197 subjects randomized to receive EPA–DHA placebo and ALA;
1236 subjects randomized to receive EPA–DHA placebo and
ALA placebo		 Major cardiovascular events:
HR = 1.01 (95% CI: 0.87–1.17, p = 0.93) with EPA–DHA;
HR = 0.91 (95% CI: 0.78–1.05, p = 0.20) with ALA
Einvik, 2010, [96] Interventional Clinical Trial 563 Norwegian men randomized to a 3-year clinical trial of diet with n-3 PUFA supplementation vs. placebo (corn oil) Mortality from any cause:
HR = 0.57 (95% CI: 0.29–1.10)
Mortality from cardiovascular diseases:
HR = 0.86 (95% CI: 0.57–1.38)
Bosch, 2012, [97] Prospective multi-centre, double-blind trial: n−3 fatty acids vs. placebo 6281 subjects randomized to receive n−3 fatty acids;
6255 subjects randomized to receive placebo		 Death from cardiovascular causes:
HR = 0.98 (95% CI: 0.87–1.10, p = 0.72)
Myocardial Infarction, Stroke, or Cardiovascular Death:
HR = 1.01 (95% CI: 0.93–1.10, p = 0.81)
Death from Any Cause:
HR = 0.98 (95% CI: 0.89–1.07, p = 0.63)
Death from Arrhythmia:
HR = 1.10 (95% CI: 0.93–1.30, p = 0.26)
Rauch, 2010, [98] Prospective randomized, placebo-controlled, double-blind, multicentre trial 1919 subjects randomized to receive n−3 fatty acids;
1885 subjects randomized to receive placebo		 Sudden cardiac death:
OR = 0.95 (95% CI: 0.56–1.60, p = 0.84)
Total mortality:
OR = 1.25 (95% CI: 0.90–1.72, p = 0.18)
Major adverse cerebrovascular and cardiovascular
Events:
OR = 1.21 (95% CI: 0.96–1.52, p = 0.10)
Revascularization in survivors:
OR = 0.93 (95% CI: 0.80–1.08, p = 0.34)
Galan, 2010, [99] Prospective randomized, placebo-controlled, double-blind trial 620 subjects randomized to receive B vitamins + omega 3
fatty acids;
633 subjects randomized to receive Omega 3 fatty acids;
622 subjects randomized to receive B vitamins;
626 subjects randomized to receive placebo		 Non-fatal myocardial infarction, stroke, or death from cardiovascular disease:
HR = 1.08 (95% CI: 0.79–1.47, p = 0.64);
Total mortality:
HR = 1.03 (95% CI: 0.72–1.48, p = 0.88)
Bonds, 2014, [100] 2 × 2 factorial-designed randomized clinical trial 1079 subjects randomized to receive lutein + zeaxanthin and DHA + EPA;
1068 subjects randomized to receive DHA + EPA;
1044 subjects randomized to receive lutein + zeaxanthin;
1012 subjects randomized to receive placebo		 Time to First Cardiovascular Disease Mortality/Morbidity Event:
HR = 0.95 (95% CI: 0.78–1.17) for DHA + EPA vs. No DHA + EPA;
HR = 0.94 (95% CI: 0.77–1.15) for Lutein + zeaxanthin vs. No Lutein + zeaxanthin
Deepak, 2019, [101] Multicentre, randomized, double-blind, placebo-controlled trial 4089 subjects randomized to receive 2 g of Icosapent Ethyl twice daily;
4090 subjects randomized to receive placebo		 Cardiovascular death, nonfatal myocardial infarction, nonfatal
stroke, coronary revascularization, or unstable angina:
HR = 0.75 (95% CI: 0.68–0.83, p < 0.001)
Bucher, 2002, [102] Meta-analysis from 11 case-control studies 7951 patients in the treatment groups and 7855 patients in the control groups Nonfatal myocardial infarction:
RR = 0.80 (95% CI: 0.5–1.2, p = 0.16) for n-3 poly-unsaturated fatty acid-enriched diets;
Fatal myocardial infarction:
RR = 0.70 (95% CI: 0.6–0.8, p < 0.001) for n-3 poly-unsaturated fatty acid-enriched diets;
Sudden death:
RR = 0.70 (95% CI: 0.6–0.9, p < 0.01) for n-3 poly-unsaturated fatty acid-enriched diets;
Overall mortality:
RR = 0.80 (95% CI: 0.7–0.9, p < 0.001) for n-3 poly-unsaturated fatty acid-enriched diets
Rizos, 2012, [103] Meta-analysis from 20 case-control studies 34,388 patients in the treatment groups and 34,292 patients in the control groups All-cause mortality:
RR = 0.96 (95% CI: 0.91–1.02) for n-3 poly-unsaturated fatty acids;
Cardiac death:
RR = 0.91 (95% CI: 0.85–0.98) for n-3 poly-unsaturated fatty acids;
Sudden death:
RR = 0.87 (95% CI: 0.75–1.01) for n-3 poly-unsaturated fatty acids;
Myocardial infarction:
RR = 0.89 (95% CI: 0.76–1.04)
for n-3 poly-unsaturated fatty acids;
Stroke:
RR = 1.05 (95% CI: 0.93–1.18)
for n-3 poly-unsaturated fatty acids
Kwak, 2012, [104] Meta-analysis from 14 placebo-control trials 10,226 patients in the treatment groups and 10,259 patients in the control groups Overall cardiovascular events:
RR = 0.99 (95% CI: 0.89–1.09) for omega-3 fatty acid supplement;
All-cause mortality:
RR = 0.96 (95% CI: 0.90–1.02) for omega-3 fatty acid supplement;
Sudden cardiac death:
RR = 0.93 (95% CI: 0.66–1.30) for omega-3 fatty acid supplement;
Cardiovascular death:
RR = 0.92 (95% CI: 0.35–1.01) for omega-3 fatty acid supplement;
Myocardial infarction:
RR = 0.81 (95% CI: 0.65–1.01)
for omega-3 fatty acid supplement;
Angina and unstable angina:
RR = 0.77 (95% CI: 0.50–1.18)
for omega-3 fatty acid supplement;
Congestive heart failure:
RR = 0.92 (95% CI: 0.73–1.17)
for omega-3 fatty acid supplement;
Transient ischemic attack and Stroke:
RR = 1.13 (95% CI: 0.77–1.66)
for omega-3 fatty acid supplement
Agency for Healthcare Research and Quality, 2016, [105] Meta-analysis from 61 randomized controlled trials and 37 longitudinal observational
studies		 No available data about sample sizes of cohorts examined All-cause death:
HR = 0.97 (95% CI: 0.92–1.03)
for EPA + DHA;
Major Adverse Cardiovascular Events:
HR = 0.96 (95% CI: 0.91–1.02)
for EPA + DHA;
Myocardial infarction:
HR = 0.88 (95% CI: 0.77–1.02)
for EPA + DHA;
Cardiovascular Disease Death:
HR = 0.92 (95% CI: 0.82–1.02)
for EPA + DHA;
Sudden Cardiac Death:
HR = 1.04 (95% CI: 0.92–1.17) for EPA + DHA;
Stroke:
HR = 0.98 (95% CI: 0.88–1.09)
for EPA + DHA
Zhang, 2018, [106] Prospective cohort study Total and cause-specific
Mortality from a cohort of 240,729 men and 180,580 women		 All-cause death:
HR = 0.89 (95% CI: 0.86–0.92, p < 0.0001)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in men;
HR = 0.90 (95% CI: 0.86–0.94, p < 0.0001)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in women;
Cancer death:
HR = 0.95 (95% CI: 0.90–1.00, p = 0.040)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in men;
HR = 1.01 (95% CI: 0.93–1.09, p = 0.51)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in women;
Cardiovascular disease death:
HR = 0.85 (95% CI: 0.80–0.90, p < 0.0001)
for highest vs. lowest quintiles of of long-chain omega-3 PUFAs intake in men;
HR = 0.82 (95% CI: 0.75–0.90, p < 0.0001)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in women;
Respiratory disease death:
HR = 0.73 (95% CI: 0.65–0.83, p < 0.0001)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in men;
HR = 0.74 (95% CI: 0.64–0.87, p < 0.0001)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in women;
Alzheimer’s Disease death:
HR = 0.70 (95% CI: 0.54–0.89, p = 0.0008)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in men;
HR = 0.59 (95% CI: 0.43–0.80, p = 0.0024)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in women;
Chronic liver disease death:
HR = 0.66 (95% CI: 0.49–0.89, p = 0.0046)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in men;
HR = 1.30 (95% CI: 0.78–2.16, p = 0.88)
for highest vs. lowest quintiles of long-chain omega-3 PUFAs intake in women