OMEGA-3 PUFA AS SECONDARY PROPHYLAXIS OF SUDDEN CARDIAC DEATH AFTER ACUTE MYOCARDIAL INFARCTION: SYSTEMATIC REVIEW AND META-ANALYSIS
Introduction. The incidence of myocardial infarction continues to grow, especially among young and middle-aged people - the incidence rate before the age of 40 reaches 35%. Survivors still have a high risk of recurrent vascular catastrophe: 18% of men and 35% of women suffer a second myocardial infarction over the next 6 years. The experience of countries, including the United States, which have achieved a significant reduction in mortality from CVD, indicates the need to actively address issues of CVD prevention based on the concept of cardiac risk factors.
The implementation of this strategy necessitates active correction of risk factors through changes in the lifestyle of patients in the direction of rehabilitation and diet therapy, which is aimed at reducing the consumption of red meat with an increase the amount of consumed seafood, which are natural sources of omega-3 PUFA.
Objective: The current review was performed to study the prophylaxis effect of omega-3 fatty acids intake and SCD in patients after AMI.
Methods: The qualitative synthesis of information in current systematic review and meta-analysis of randomized controlled trials obtained from studies selected from databases Web of Science, PUBMED and e-library on inclusion criteria (RCT in English and Russian languages, without time limits) was supplemented by quantitative synthesis in the form of a meta-analysis, for which random-effects models were used, as the most robust and admitting of heterogeneity of individual research results. Weighted RR and I2 were calculated. All results are presented with 95% confidence (CI) and predictive (PI) intervals.
Results: The weighted RR was 0,83 (95% CI:0,59; 1,18). Significant heterogeneity was detected (Q test = 19,50; df=4, p<0,001). RR variability of individual studies by 80% (95% CI: 51; 91) was due to this heterogeneity according to indicator I2. The 95% predictive interval for R was 0,26-2,61.
Conclusions: Based on a current systematic review and meta-analysis, it can be concluded that there is no evidence of prevention of SCD in patients after AMI from prescribing sources of omega-3 PUFA. Large well-designed trials are warranted to confirm or refute our results.
Raushan Sh. Tuleuova 1, https://orcid.org/0000-0002-0964-3841
Andrej M. Grjibovski 1-4, http://orcid.org/0000-0002-5464-0498
Lazzat M. Zhamaliyeva 1, http://orcid.org/0000-0003-3625-3651
Damira G. Zhamankulova 1, https://orcid.org/0000-0001-6943-0664
1 West Kazakhstan Marat Ospanov State Medical University, Aktobe, Republic of Kazakhstan;
2 North-Eastern Federal University, Yakutsk, Russian Federation;
3 Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan;
4 Northern State Medical University, Arkhangelsk, Russian Federation.
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Тулеуова Р.Ш., Гржибовский А.М., Жамалиева Л.М., Жаманкулова Д.Г. Оценка эффективности Омега-3 жирных кислот для вторичной профилактики внезапной сердечной смерти у пациентов с инфарктом миокарда: систематический обзор и мета анализ // Наука и Здравоохранение. 2019. 1 (Т.21). С. 7-20. Tuleuova R.Sh., Grjibovski A.M., Zhamaliyeva L.M., Zhamankulova D.G. Omega-3 PUFA as secondary prophylaxis of sudden cardiac death after acute myocardial infarction: systematic review and meta-analysis. Nauka i Zdravookhranenie [Science & Healthcare]. 2019, (Vol.21) 1, pp. 7-20. Тулеуова Р.Ш., Гржибовский А.М., Жамалиева Л.М., Жаманкулова Д.Г. Жедел жүрек инфарктісі бар науқастарда жедел жүрек өлімінің екінші профилактикасы ретінде Омега-3 май қышқылдарын пайдалану: жүйелік шолу және мета анализ // Ғылым және Денсаулық сақтау. 2019. 1 (Т.21). Б. 7-20.Related publications:
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