Omega-3 fatty acids and mortality outcome in patients with and without type 2 diabetes after myocardial infarction: a retrospective, matched-cohort study

Poole, Christopher David, Halcox, Julian, Jenkins-Jones, Sara, Carr, Emma S.M., Schifflers, Mathias G., Ray, Kausik K. and Currie, Craig J. 2013. Omega-3 fatty acids and mortality outcome in patients with and without type 2 diabetes after myocardial infarction: a retrospective, matched-cohort study. Clinical Therapeutics 35 (1) , pp. 40-51. 10.1016/j.clinthera.2012.11.008

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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

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > R Medicine (General)
Uncontrolled Keywords:	All-cause mortality; n-3 fatty acids; omega-3 fatty acids; ORIGIN trial; type 2 diabetes.
Publisher:	Elsevier
ISSN:	0149-2918
Date of First Compliant Deposit:	30 March 2016
Last Modified:	03 May 2023 10:34
URI:	https://orca.cardiff.ac.uk/id/eprint/62488

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