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Published on: February 26, 2013
N-3 polyunsaturated fatty acids administration does not reduce the recurrence rates of atrial fibrillation and
Mehmet Ozaydın1, Doğan Erdoğan, Senol Tayyar
1Department of Cardiology, Faculty of Medicine, Süleyman Demirel University, Isparta, Turkey. mehmetozaydin@hotmail.com
Insights
N-3 polyunsaturated fatty acids did not reduce atrial fibrillation recurrence or inflammation after electrical cardioversion. This study found no significant difference in AF recurrence rates between groups receiving amiodarone versus amiodarone plus n-3 polyunsaturated fatty acids.
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- Atrial fibrillation (AF) recurrence after electrical cardioversion is a clinical challenge.
- Inflammation, measured by high-sensitivity C-reactive protein (hs-CRP), is linked to AF.
- N-3 polyunsaturated fatty acids (PUFAs) have anti-inflammatory properties.
Purpose of the Study:
- To investigate the efficacy of n-3 PUFAs in preventing AF recurrence post-cardioversion.
- To assess the impact of n-3 PUFAs on inflammatory markers, specifically hs-CRP.
Main Methods:
- Prospective randomized study with 47 patients undergoing electrical cardioversion.
- Patients randomized to amiodarone or amiodarone plus n-3 PUFAs.
- 12-month follow-up for AF recurrence; hs-CRP levels measured at baseline, day 15, and during recurrence.
Main Results:
- AF recurrence rates were similar between groups: 37.5% in the amiodarone group and 39.1% in the n-3 PUFA group (p=1).
- Previous cardioversion and elevated hs-CRP levels were significant risk factors for AF recurrence.
- No significant differences in hs-CRP levels were observed between the groups throughout the study.
Conclusions:
- N-3 PUFA supplementation does not significantly reduce AF recurrence rates after electrical cardioversion.
- N-3 PUFAs did not demonstrate a significant effect on reducing inflammation as measured by hs-CRP levels.
Objective:
The purpose of the present prospective randomized study was to evaluate the effects of n-3 polyunsaturated fatty acids on recurrence rates of atrial fibrillation (AF) and inflammation after electrical cardioversion.
Methods:
Calculation of the number of patients needed was based on the assumption of 20% and 65% chance of maintaining sinus rhythm with amiodarone and with polyunsaturated fatty acids, respectively. To observe a significant difference with an alpha level of 0.05 and a power of 0.80 it was necessary to include 22 patients in each group. A total of 47 patients were randomized to amiodarone (n=24) and amiodarone plus n-3 polyunsaturated fatty acids (n=23) groups before scheduled electrical cardioversion. The end-point was the recurrence of AF during 12-month follow-up. Effect of n-3 polyunsaturated fatty acids on inflammation was evaluated with high sensitivity C-reactive protein level measurements. Statistical analysis was performed using unpaired Student' t, Mann Whitney U and Chi-square tests. We analyzed the recurrence of AF using the Cox proportional hazards regression model to control for potentially confounding factors.
Results:
Nine patients in the amiodarone group (37.5%), and 9 patients in the amiodarone plus n-3 polyunsaturated fatty acids group (39.1%) had recurrence of AF during follow-up (p=1). With the Cox proportional model, risk factors for the recurrence of AF were previous electrical cardioversion (HR 10.33, 95% CI 1.74 to 61.10, p=0.01) and high sensitivity C-reactive protein levels (HR 1.07, 95% CI 1.02 to 1.38, p=0.007). High sensitivity C-reactive protein levels at baseline, at day 15 and during AF recurrence were similar between two groups (p > 0.05 for all).
Conclusion:
N-3 polyunsaturated fatty acids administration does not reduce the recurrence rates of atrial fibrillation and inflammation.
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