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Efectos del tratamiento con ácidos grasos omega-3 sobre el riesgo de fibrilación auricular: un metaanálisis
Nada R Abuknesha1, James H O'Keefe1,2, Frank Qian3
1Fatty Acid Research Institute, Sioux Falls, SD, USA.
medRxiv : the preprint server for health sciences
|December 25, 2025
Resumen
Los ácidos grasos omega-3 (EPA/DHA) pueden aumentar el riesgo de fibrilación auricular (FA), especialmente en pacientes con enfermedad cardiovascular de alto riesgo que toman dosis altas. Equilibrar estos riesgos frente a los beneficios es crucial para las decisiones de tratamiento.
Área de la Ciencia:
- Cardiología
- Farmacología
- Epidemiología
Sus antecedentes:
- Metanálisis recientes sugieren que los ácidos grasos omega-3 pueden aumentar el riesgo de fibrilación auricular (FA).
- Metanálisis anteriores se vieron limitados por un pequeño número de ensayos controlados aleatorizados (ECR) incluidos.
Objetivo del estudio:
- Realizar un metaanálisis exhaustivo de ECR sobre los ácidos grasos omega-3 y la incidencia de FA.
- Investigar el impacto sinérgico de la dosis de omega-3 y el riesgo de enfermedad cardiovascular (ECV) en la aparición de FA.
Principales métodos:
- Se incluyeron ECR con ≥500 mg/día de ácido docosahexaenoico (DHA) y/o ácido eicosapentaenoico (EPA) durante ≥12 meses.
- Se centró en participantes ≥50 años, preferiblemente sin FA/flutter auricular preexistente.
- Se analizó la FA de nueva aparición como resultado principal, estratificando por dosis de EPA/DHA y riesgo de ECV.
Principales resultados:
- Se analizaron 34 ECR (n=114.326).
- Se observó un aumento significativo del riesgo de FA (OR 1,48) solo en pacientes con alto riesgo de ECV que recibieron dosis altas de EPA/DHA (>1500 mg/día).
- No se encontró un aumento significativo del riesgo de FA en otros grupos (alto riesgo/dosis baja, bajo riesgo/dosis baja, bajo riesgo/dosis alta).
Conclusiones:
- El tratamiento con EPA/DHA supone un mayor riesgo de FA principalmente en personas con alto riesgo de ECV que utilizan dosis altas.
- Las decisiones clínicas requieren equilibrar el riesgo potencial de FA frente a los beneficios establecidos de la terapia con EPA/DHA.
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