1. Omega-3 Fatty Acids and Mortality Outcome in Patients With and Without Type 2 Diabetes After Myocardial Infarction: A Retrospective, Matched-Cohort Study.
- Author
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Poole, Chris D., Halcox, Julian P., Jenkins-Jones, Sara, Carr, Emma S. M., Schifflers, Mathias G., Ray, Kausik K., and Currie, Craig J.
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THERAPEUTIC use of omega-3 fatty acids , *ACADEMIC medical centers , *BLOOD testing , *CONFIDENCE intervals , *DATABASES , *LONGITUDINAL method , *MORTALITY , *MYOCARDIAL infarction , *TYPE 2 diabetes , *OMEGA-3 fatty acids , *HEALTH outcome assessment , *RESEARCH funding , *TREATMENT effectiveness , *PROPORTIONAL hazards models , *RETROSPECTIVE studies , *CASE-control method , *DESCRIPTIVE statistics - Abstract
Background: There are conflicting data regarding the benefits of omega-3 (n-3) fatty acids, most recently in patients with type 2 diabetes. Objective: Our goal was to evaluate the impact of licensed, highly purified n-3 fatty acids on all-cause mortality after myocardial infarction (MI). Methods: This was a retrospective, matched-cohort study using data from the General Practice Research Database. Patients initiating treatment with 1 g of n-3 fatty acids in the 90 days after first MI were identified and each matched to 4 nonexposed patients. Progression to death was compared using time-dependent Cox models to account for potential differences in exposure to other cardiovascular risk-modifying treatments. Results: A total of 2466 eligible subjects exposed to n-3 fatty acids were matched. The majority of patients had concurrent treatment with lipid-lowering therapies, antihypertensives, and antiplatelets after first MI, with subjects exposed to n-3 fatty acids having a greater likelihood of concurrent exposure. For those initiating n-3 fatty acids within 90 days of first MI, the adjusted hazard ratio (aHR) was 0.782 (95% CI, 0.641-0.995; P = 0.0159); for those initiating treatment within 14 days, the aHR was 0.680 (95% CI, 0.481-0.961; P = 0.0288). In patients with type 2 diabetes at baseline, the aHRs were 0.714 (95% CI, 0.454-1.124) and 0.597 (95% CI, 0.295-1.211) when initiation was within 90 and 14 days, respectively. Use of n-3 fatty acids resulted in a consistent survival benefit under a range of scenarios quantitatively consistent with the overall effect. Conclusion: After MI, early treatment with licensed n-3 fatty acids was associated with improvement in all-cause mortality in patients with and without type 2 diabetes, against a background of contemporary cardiovascular risk-modifying treatments. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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