Heart Failure

Omega-3 Fatty Acid Supplementation

• Intervention
  In patients with heart failure (NYHA Classes I - IV/AHA Stages B and C), what is the effect of omega-3 fatty acid supplementation on quality of life, signs & symptoms?

  • Conclusion
    In patients with heart failure (NYHA Classes I - IV/AHA Stages B and C), research reported that the group receiving 2 g/day of omega-3 polyunsaturated fatty acids for one year had a significant decrease in NYHA functional class compared to an increase in the placebo group. However, since omega 3 fatty acid supplementation may increase the effects of blood thinning agents such as warfarin, aspirin, clopedigrel, and vitamin E, it is unclear whether this dose and duration of omega-3 fatty acids would be appropriate for patients with heart failure. Research is needed regarding the effect of omega-3 fatty acid supplementation on quality of life in patients with heart failure.
  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In patients with heart failure (NYHA Classes I - IV/AHA Stages B and C), what is the effect of omega-3 fatty acid supplementation on quality of life, signs & symptoms?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Nodari S, Triggiani M, Campia U, Manerba A, Milesi G, Cesana B, Gheorghiade M, Dei Cas L. Effects of n-3 polyunsaturated fatty acids on left ventricular function and functional capacity in patients with dilated cardiomyopathy. Journal of the American College of Cardiology 2011; 57:870-9
  • Search Plan and Results: HF: Supplements (2014)
     
  In patients with heart failure (NYHA Classes I - IV/AHA Stages B and C), what is the effect of omega-3 fatty acid supplementation on renal function labs and clinical labs?

  • Conclusion
    In patients with heart failure (NYHA Classes I-IV/AHA Stages B and C), research reported that omega-3 fatty acid supplementation, at the level of 2 g/day for three to six months, resulted in significant decreases in BNP levels. However, since omega 3 fatty acid supplementation may increase the effects of blood thinning agents such as warfarin, aspirin, clopedigrel, and vitamin E, it is unclear whether this dose and duration of omega-3 fatty acids would be appropriate for patients with heart failure. Research is needed regarding the effect of omega-3 fatty acid supplementation on BUN, creatinine and serum sodium in patients with heart failure.
  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In patients with heart failure (NYHA Classes I - IV/AHA Stages B and C), what is the effect of omega-3 fatty acid supplementation on renal function labs and clinical labs?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Kojuri J, Ostovan M, Rezaian G, Archin Dialameh P, Zamiri N, Sharifkazemi M, Jannati M. Effect of omega-3 on brain natriuretic peptide and echocardiographic findings in heart failure: Double-blind placebo-controlled randomized trial. Journal of Cardiovascular Disease Research 2013; 4:20-4
      • Masson S, Marchioli R, Mozaffarian D, Bernasconi R, Milani V, Dragani L, Tacconi M, Marfisi R, Borgese L, Cirrincione V, Febo O, Nicolis E, Maggioni A, Tognoni G, Tavazzi L, Latini R. Plasma N-3 polyunsaturated fatty acids in chronic heart failure in the GISSI-Heart Failure Trial: Relation with fish intake, circulating biomarkers and mortality. American Heart Journal 2013; 165:208-15.e4
      • Zhao Y,Shao L,Teng L,Hu B,Luo Y,Yu X,Zhang D,Zhang H. Effects of n-3 polyunsaturated fatty acid therapy on plasma inflammatory markers and N-terminal pro-brain natriuretic peptide in elderly patients with chronic heart failure. The Journal of international medical research 2009; 37:1831-41
  • Search Plan and Results: HF: Supplements (2014)
     
  In patients with heart failure (NYHA Classes I to IV/AHA Stages B and C), what is the effect of omega-3 fatty acid supplementation on quality measures (re-admissions rate, length of stay, mortality)?

  • Conclusion
    In patients with heart failure (NYHA Classes I to IV/AHA Stages B and C), research reported that omega-3 fatty acid supplementation had no significant effect on mortality rates, but the effect of 2g per day for six months to one year showed mixed results on hospitalization rates. However, since omega 3 fatty acid supplementation may increase the effects of blood-thinning agents such as warfarin, aspirin, clopedigrel and vitamin E, it is unclear whether this dose and duration of omega-3 fatty acids would be appropriate for patients with heart failure. Research is needed regarding the effect of omega-3 fatty acid supplementation on length of stay in patients with heart failure.
    
     
  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: In patients with heart failure (NYHA Classes I–IV/AHA Stages B and C), what is the effect of omega-3 fatty acid supplementation on quality measures (re-admissions rate, length of stay, mortality)?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Kojuri J, Ostovan M, Rezaian G, Archin Dialameh P, Zamiri N, Sharifkazemi M, Jannati M. Effect of omega-3 on brain natriuretic peptide and echocardiographic findings in heart failure: Double-blind placebo-controlled randomized trial. Journal of Cardiovascular Disease Research 2013; 4:20-4
      • Masson S, Marchioli R, Mozaffarian D, Bernasconi R, Milani V, Dragani L, Tacconi M, Marfisi R, Borgese L, Cirrincione V, Febo O, Nicolis E, Maggioni A, Tognoni G, Tavazzi L, Latini R. Plasma N-3 polyunsaturated fatty acids in chronic heart failure in the GISSI-Heart Failure Trial: Relation with fish intake, circulating biomarkers and mortality. American Heart Journal 2013; 165:208-15.e4
      • Nodari S, Triggiani M, Campia U, Manerba A, Milesi G, Cesana B, Gheorghiade M, Dei Cas L. Effects of n-3 polyunsaturated fatty acids on left ventricular function and functional capacity in patients with dilated cardiomyopathy. Journal of the American College of Cardiology 2011; 57:870-9
  • Search Plan and Results: HF: Supplements (2014)
     
  In patients with advanced heart failure (NYHA Class IV/AHA Stage D), what is the effect of omega-3 fatty acid supplementation on quality measures (re-admissions rate, length of stay, mortality)?

  • Conclusion
    In patients with advanced heart failure (NYHA Class IV/AHA Stage D), there were no studies identified that reported on the effect of omega-3 fatty acid supplementation on quality measures.
  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: HF: Supplements (2014)
     
  In patients with advanced heart failure (NYHA Class IV/AHA Stage D), what is the effect of omega-3 fatty acid supplementation on quality of life, signs and symptoms?

  • Conclusion
    In patients with advanced heart failure (NYHA Class IV/AHA Stage D), there were no studies identified that reported on the effect of omega-3 fatty acid supplementation on quality of life, signs and symptoms.
  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: HF: Supplements (2014)
     
  In patients with advanced heart failure (NYHA Class IV/AHA Stage D), what is the effect of omega-3 fatty acid supplementation on renal function labs and clinical labs?

  • Conclusion
    In patients with advanced heart failure (NYHA Class IV/AHA Stage D), there were no studies identified that reported on the effect of omega-3 fatty acid supplementation on renal function labs and clinical labs.
  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: HF: Supplements (2014)