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Meta Analysis: Omega 3 Fatty Acids Against Postoperative Atrial Fibrillation
Meta-analysis reaffirms protective effect of preoperative omega-3 fatty acids against postoperative atrial fibrillationFriday, May 10, 2013. The results of an updated meta-analysis published online on April 12, 2013 in the Journal of Thoracic and Cardiovascular Surgery indicate that preoperative supplementation with omega-3 polyunsaturated fatty acids provides significant protection against atrial fibrillation in open heart surgery patients. Atrial fibrillation is the most common type of heart arrhythmia that occurs after heart surgery, and can result in longer hospitalization and an increase risk of postoperative mortality. "Current guidelines recommend the use of antiarrhythmic drugs to decrease the risk of postoperative atrial fibrillation after cardiac surgery," authors Simona Costanzo and her colleagues at Italy's Univerisita Cattolica write. "However, the patient is not fully protected from postoperative atrial fibrillation by using only these agents; thus, newer therapies (nonantiarrhythmic drugs) for the management of atrial fibrillation are needed to be used in combination with them." The analysis included eight randomized clinical trials evaluating the efficacy of omega-3 fatty acids for the prevention of atrial fibrillation following coronary artery bypass graft surgery and/or heart valve surgery in 2,687 men and women. A total of 398 atrial fibrillation events were documented postoperatively. Among subjects who received omega-3 fatty acids, there was a 16% lower risk of atrial fibrillation in comparison with those who received a placebo. When the analysis was limited to coronary artery bypass graft surgery patients, the reduction in risk associated with omega-3 supplementation increased to 34%. In their discussion of the findings, the authors remark that factors associated with atrial fibrillation include advanced age, diabetes, and intraoperative and other factors, and that the common pathways of all of these factors involve inflammation and oxidative stress. The benefit of omega-3 fatty acids in preventing postoperative atrial fibrillation could be due to their anti-inflammatory property or a direct antiarrhythmic effect. The authors suggest that preoperative omega-3 fatty acid supplementation should be tested in future studies of patients undergoing a single type of heart surgery procedure. |
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