Gao Zheng, Zhang Dewen, Yan Xiaocan, Shi Hekai, Xian Xiaohui
Department of Internal Medicine, The Second Affiliated Hospital of Hebei Medical University, Shijiazhuang, China.
Department of Pathophysiology, College of Basic Medicine, Hebei Medical University, Shijiazhuang, China.
Front Cardiovasc Med. 2022 Jun 20;9:904250. doi: 10.3389/fcvm.2022.904250. eCollection 2022.
Multiple guidelines suggest the ω-3 polyunsaturated fatty acids (ω-3 PUFAs) help to prevent major vascular events of coronary heart disease (CHD), but the data on large trials of ω-3 fatty acids are controversial. We reviewed the available evidence to determine the effect of ω-3 PUFAs on coronary atherosclerosis.
Literature were from online databases. Randomized controlled trials (RCTs) or observational studies were acceptable. Quantitative data synthesis was conducted using R version 4.1.2. Each outcome was calculated using standardized mean difference (SMD) in a random-effect model. Sensitivity analysis was conducted for each outcome. A total of 21 RCTs and 1 observational study with 2,277 participants were included.
Meta-analysis indicated a benefit of ω-3 PUFAs on coronary atherosclerosis, namely, (1) ω-3 PUFAs can reduce the atherosclerotic plaque volume (SMD -0.18; 95% CI -0.31 to -0.05); (2) ω-3 PUFAs can help reduce the loss of the diameter of the narrowest segments of coronary arteries in patients with CHD (SMD 0.29; 95% CI, 0.05-0.53); (3) ω-3 PUFAs do not have significant effect on volume of lipid plaque in coronary arteries (SMD -1.18; 95% CI -2.95 to 0.58), volume of fiber plaque (SMD 0.26; 95% CI -0.81 to 1.33), and calcified plaque (SMD 0.17; 95% CI -0.55 to 0.89); and (4) ω-3 PUFAs had no significant effect on endothelial inflammatory factors in peripheral blood.
We confirmed that ω-3 PUFAs benefit patients with CHD by reducing the progression of coronary atherosclerosis. We indicated that the benefits were not caused by reducing endothelial inflammations of coronary arteries.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021285139, identifier: CRD42021285139.
多项指南表明，ω-3多不饱和脂肪酸（ω-3 PUFAs）有助于预防冠心病（CHD）的主要血管事件，但关于ω-3脂肪酸大型试验的数据存在争议。我们回顾了现有证据，以确定ω-3 PUFAs对冠状动脉粥样硬化的影响。
文献来自在线数据库。随机对照试验（RCTs）或观察性研究均可接受。使用R版本4.1.2进行定量数据合成。每个结果均采用随机效应模型中的标准化均数差（SMD）进行计算。对每个结果进行敏感性分析。共纳入21项RCTs和1项观察性研究，涉及2277名参与者。
荟萃分析表明ω-3 PUFAs对冠状动脉粥样硬化有益，即：（1）ω-3 PUFAs可减少动脉粥样硬化斑块体积（SMD -0.18；95%CI -0.31至-0.05）；（2）ω-3 PUFAs有助于减少冠心病患者冠状动脉最狭窄节段直径的减小（SMD 0.29；95%CI，0.05 - 0.53）；（3）ω-3 PUFAs对冠状动脉脂质斑块体积（SMD -1.18；95%CI -2.95至0.58）、纤维斑块体积（SMD 0.26；95%CI -0.81至1.33）和钙化斑块（SMD 0.17；95%CI -0.55至0.89）无显著影响；（4）ω-3 PUFAs对外周血中的内皮炎症因子无显著影响。
我们证实ω-3 PUFAs通过减少冠状动脉粥样硬化的进展使冠心病患者受益。我们指出，这种益处并非由减轻冠状动脉内皮炎症引起。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021285139，标识符：CRD42021285139。
