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All-Cause Mortality and Cardiovascular Death between Statins and Omega-3 Supplementation: A Meta-Analysis and Network

Jeongseon Kim1, Tung Hoang1, Ji-Myung Kim2

  • 1Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang 10408, Korea.

Nutrients
|October 23, 2020
PubMed

Insights

Statins significantly reduce all-cause mortality and cardiovascular disease (CVD) death compared to placebo. Omega-3 fatty acids show a significant reduction in CVD death but only a borderline effect on all-cause mortality, suggesting statins may be more effective.

Area of Science:

  • Cardiovascular disease (CVD) prevention
  • Pharmacological interventions and nutritional supplements
  • Mortality outcome analysis

Background:

  • Statins and omega-3 fatty acids are recognized for their potential in cardiovascular disease (CVD) prevention.
  • Comparative effectiveness of statins versus omega-3 supplementation on mortality outcomes remains under-investigated.
  • Previous research has not comprehensively evaluated these interventions across primary, secondary, and mixed prevention populations.

Purpose of the Study:

  • To investigate the effect of statins and omega-3 supplementation on mortality.
  • To indirectly compare the efficacy of statin use versus omega-3 fatty acids in reducing all-cause mortality and CVD death.
  • To analyze these effects in different patient populations including primary prevention, secondary prevention, and mixed groups.

Main Methods:

  • A frequentist network meta-analysis was conducted, including randomized controlled trials (RCTs) from meta-analyses published up to December 2019.
  • Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated to indirectly compare statin use and omega-3 supplementation.
  • Fifty-five RCTs were included in the final analysis, examining outcomes for all-cause mortality and CVD death.

Main Results:

  • Statins significantly reduced all-cause mortality (RR = 0.90, 95% CI = 0.86-0.94) and CVD death (RR = 0.86, 95% CI = 0.80-0.92) compared to placebo.
  • Omega-3 supplementation showed a borderline effect on all-cause mortality (RR = 0.97, 95% CI = 0.94-1.01) but significantly reduced CVD death (RR = 0.92, 95% CI = 0.87-0.98).
  • Network meta-analysis indicated a significant difference in all-cause mortality favoring statins over omega-3s in the overall population (RR = 0.91, 95% CI = 0.85-0.98).

Conclusions:

  • Statin use appears to be associated with a lower risk of all-cause mortality compared to omega-3 supplementation.
  • While both interventions reduce CVD death, statins demonstrate a more pronounced effect on all-cause mortality.
  • Further direct comparative studies are warranted to definitively confirm the relative benefits of statins versus omega-3 supplementation.

Keywords:
cardiovascular diseasemortalitynetwork meta-analysisomega-3statin

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