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Omega-3 fatty acids have gotten a heart-healthy reputation without good evidence that they actually prevent major cardiovascular disease events, according to a meta-analysis.

Across 10 large randomized trials lasting at least 1 year, taking the supplements was not associated with significantly reduced risk of:

• Death from coronary heart disease: rate ratio 0.93 (99% CI 0.83-1.03)
• Nonfatal myocardial infarction: RR 0.97 (99% CI 0.87-1.08)
• Any coronary heart disease events: RR 0.96 (95% CI 0.90-1.01)
• Major vascular events: RR 0.97 (95% CI 0.93-1.01)

Benefits also weren't seen in subgroups with prior coronary heart disease, diabetes, elevated lipid levels, or statin use, Robert Clarke, MD, of the University of Oxford in England, and colleagues reported in JAMA Cardiology.

While the European Society of Cardiology has called a protective effect of omega-3s , the American Heart Association has for secondary prevention of coronary heart disease in patients with recent events and "might also be considered" in people with heart failure and reduced ejection fraction.

"However, the results of the present meta-analysis provide no support for the recommendations to use approximately 1 g/d of omega-3 FAs in individuals with a history of CHD for the prevention of fatal CHD, nonfatal MI, or any other vascular events," Clarke's group concluded. "The results of the ongoing trials are needed to assess if higher doses of omega-3 [fatty acids] (3-4 g/d) may have significant effects on risk of major vascular events."

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