Center for Molecular Cardiology, Laboratory for Platelet Research, University of Zurich, Schlieren, Switzerland.
Department of Internal Medicine, Cantonal Hospital of Baden, Baden, Switzerland.
J Thromb Haemost. 2017 Jan;15(1):47-56. doi: 10.1111/jth.13553.
Essentials The role of omega-3 fatty acids (n-3 FAs) in recurrent venous thromboembolism (VTE) is unknown. Association of n-3 FAs with recurrent VTE or total mortality was investigated in 826 patients. Whole blood n-3 FAs were inversely correlated with recurrent VTE or total mortality. Major and non-major bleeding was not increased in patients with higher levels of n-3 FAs.
Background The role of omega-3 fatty acids (n-3 FAs) in recurrent venous thromboembolism (VTE) remains unknown. Objectives To investigate the association of n-3 FAs with recurrent VTE or total mortality at 6 months and 3 years. Methods N-3 FAs were assessed in 826 patients aged ≥ 65 years, categorized into low, medium and high based on the 25th and 75th percentile. Mean follow-up was 29 months. Results At 6 months, subjects with medium (adjusted hazard ratio [HR], 0.37; 95% confidence interval [CI], 0.22-0.62) and high n-3 FA levels (adjusted HR, 0.36; 95% CI, 0.20-0.67) were less likely to develop recurrent VTE or total mortality, compared with those with low n-3 FAs. At 3 years, medium levels (adjusted HR, 0.67; 95% CI, 0.47-0.96) were associated with lower risk of recurrent VTE or total mortality. As compared with low n-3 FAs, the adjusted sub-hazard ratio [SHR] of recurrent VTE was 0.39 (95% CI, 0.15-0.99) in patients with medium and 0.17 (95% CI, 0.03-0.82) in patients with high n-3 FAs. The cumulative incidence of recurrent VTE was lower in the medium and high n-3 FA groups as compared with the low n-3 FA groups, but seems to have worn off after 3 years. The incidence of major and non-major bleeding was not greater in the high n-3 FA group. Conclusion Higher levels of n-3 FAs were associated with a lower risk of recurrent VTE or total mortality in elderly patients with VTE, but not with greater bleeding risk.
目的 研究 ω-3 脂肪酸(n-3 FAs)与复发性静脉血栓栓塞症(VTE)或总死亡率之间的相关性。
方法 对 826 名年龄≥65 岁的患者进行 n-3 FAs 评估,根据第 25 和 75 百分位数分为低、中、高 n-3 FA 组。平均随访 29 个月。
结果 6 个月时,中 n-3 FA 水平组(校正后的风险比 [HR],0.37;95%置信区间 [CI],0.22-0.62)和高 n-3 FA 水平组(校正后的 HR,0.36;95% CI,0.20-0.67)发生复发性 VTE 或总死亡率的可能性低于低 n-3 FA 水平组。3 年后,中 n-3 FA 水平组(校正后的 HR,0.67;95% CI,0.47-0.96)与较低的复发性 VTE 或总死亡率风险相关。与低 n-3 FAs 相比,中 n-3 FAs 患者的复发性 VTE 校正亚危险比(SHR)为 0.39(95% CI,0.15-0.99),高 n-3 FAs 患者为 0.17(95% CI,0.03-0.82)。与低 n-3 FA 组相比,中 n-3 FA 组和高 n-3 FA 组的复发性 VTE 累积发生率较低,但在 3 年后似乎已经消失。高 n-3 FA 组的主要和非主要出血发生率并未增加。
结论 与低 n-3 FA 组相比,VTE 老年患者 n-3 FAs 水平较高与复发性 VTE 或总死亡率风险降低相关,但与更高的出血风险无关。