Evidence map›Paper›PMID 42517224›Full record

SynthesisCirculation. Arrhythmia and electrophysiology2026

Effects of Omega-3 Fatty Acid Treatment on Risk for Atrial Fibrillation: An Updated Meta-Analysis of 35 Trials including 114 592 Individuals.

Nada R Abuknesha, James H O'Keefe, Frank Qian, Nathan L Tintle, Yidie Lin, Yue Sun, Han-Zhu Qian, Paul S Aisen, Christine M Albert, William J Aronson and 29 more

Abstract readMeta-AnalysisReview
In one paragraph

Synthesis in Circulation. Arrhythmia and electrophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

39 authors.

Nada R AbukneshaFatty Acid Research Institute, Sioux Falls, SD (N.R.A., J.H.O.K., N.L.T., W.S.H.).ORCID 0000-0001-5602-2979
James H O'KeefeFatty Acid Research Institute, Sioux Falls, SD (N.R.A., J.H.O.K., N.L.T., W.S.H.).ORCID 0000-0002-3376-5822
Frank QianSection of Cardiovascular Medicine, Boston Medical Center & Boston University Chobanian & Avedisian School of Medicine, MA (F.Q.).ORCID 0000-0002-5579-3410
Nathan L TintleFatty Acid Research Institute, Sioux Falls, SD (N.R.A., J.H.O.K., N.L.T., W.S.H.).ORCID 0000-0003-1447-9107
Yidie LinDepartment of Epidemiology & Health Statistics, West China School of Public Health & West China Fourth Hospital, Sichuan University, Chengdu (Y.L., Y.S.).ORCID 0000-0001-9483-701X
Yue SunDepartment of Epidemiology & Health Statistics, West China School of Public Health & West China Fourth Hospital, Sichuan University, Chengdu (Y.L., Y.S.).
Han-Zhu QianGlaxoSmithKline, Rockville, MD (H.-Z.Q.).ORCID 0000-0003-2785-2628
Paul S AisenAlzheimer's Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego (P.S.A.).ORCID 0000-0002-2896-5838
Christine M AlbertDepartment of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (C.M.A.).ORCID 0000-0002-2081-1121
William J AronsonDepartment of Urology, David Geffen School of Medicine, University of California Los Angeles (W.J.A., A.L.).
Abdul Aziz A AsbeutahDepartment of Medicine, Division of Cardiovascular Medicine, University of Wisconsin-Madison Hospitals & Clinics (A.A.A.A.).
Heike A Bischoff-FerrariDepartment of Aging Medicine, University of Basel, Felix Platter, Switzerland (H.A.B.-F.).
Matthew J BudoffDepartment of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA (M.J.B.).ORCID 0000-0002-9616-1946
Nicholas R BurnsSchool of Psychology, University of Adelaide, Australia (N.R.B.).ORCID 0000-0003-3456-6734
Cecilia A CardenasDivision of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine & Public Health (C.A.C., C.M.C., C.A.V.H.).ORCID 0009-0003-0455-5599
Cynthia M CarlssonDivision of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine & Public Health (C.A.C., C.M.C., C.A.V.H.).ORCID 0000-0001-5743-1563
Emily Y ChewDivision of Epidemiology & Clinical Applications, National Eye Institute/National Institute of Health, Bethesda, MD (E.Y.C., C.W.).ORCID 0000-0003-0999-9802
Neal J CohenBeckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Urbana (N.J.C.).
Léopold K FezeuUniversité Sorbonne Paris Nord & Université Paris Cité, INSERM, INRAE, CNAM, Centre for Research in Epidemiology & StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France (L.K.F., P.G.).
Amana LiddellDepartment of Urology, David Geffen School of Medicine, University of California Los Angeles (W.J.A., A.L.).ORCID 0009-0001-1296-2093
Pilar GalanUniversité Sorbonne Paris Nord & Université Paris Cité, INSERM, INRAE, CNAM, Centre for Research in Epidemiology & StatisticS (CRESS), Nutritional Epidemiology Research Team (EREN), Bobigny, France (L.K.F., P.G.).
Mark A HullLeeds Institute of Medical Research, University of Leeds, St James's University Hospital, United Kingdom (M.A.H.).ORCID 0000-0001-7414-1576
Tsuo-Hung LanTsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou (T.-H.L.).ORCID 0000-0002-2796-1026
Pan-Yen LinDepartment of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital (P.-Y.L., K.-P.S.).ORCID 0000-0002-0376-4562
Alexia MengelbergSchool of Psychology, Massey University Wellington, New Zealand (A.M.).
Anne-Marie MinihaneDepartment of Nutrition & Preventive Medicine, Norwich Medical School, BCRE (A.-M.M., D.V.).ORCID 0000-0001-9042-4226
Joseph F QuinnDepartment of Neurology, Oregon Health & Science University, Portland (J.F.Q.).ORCID 0000-0001-7305-2256
Thomas A B SandersDepartment of Nutritional Sciences, King's College London (T.A.B.S.).ORCID 0000-0001-9529-095X
Andrew ScholeySchool of Psychology, Northumbria University, Newcastle-upon-Tyne, United Kingdom (A.S.).ORCID 0000-0003-4484-5462
David A SchoenfeldDepartment of Medicine (C.M.A., D.A.S.), Massachusetts General Hospital, Boston.
Kirsty SprangeNottingham Clinical Trials Unit, School of Medicine, University of Nottingham, United Kingdom (K.S.).ORCID 0000-0001-6443-7242
Kuan-Pin SuDepartment of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital (P.-Y.L., K.-P.S.).ORCID 0000-0002-4501-2502
Christopher H van DyckDepartment of Psychiatry, Yale University, New Haven, CT (C.H.D.).ORCID 0000-0003-1779-097X
Carol A Van HulleDivision of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine & Public Health (C.A.C., C.M.C., C.A.V.H.).ORCID 0000-0002-2288-8819
David VauzourDepartment of Nutrition & Preventive Medicine, Norwich Medical School, BCRE (A.-M.M., D.V.).ORCID 0000-0001-5952-8756
Claire WeberDivision of Epidemiology & Clinical Applications, National Eye Institute/National Institute of Health, Bethesda, MD (E.Y.C., C.W.).ORCID 0000-0002-2352-8479
Francine K WeltyDivision of Nutrition, Harvard Medical School, Boston, MA (F.K.W.).ORCID 0000-0002-0091-406X
Gary WittertSchool of Medicine, University of Adelaide, Australia (G.W.).ORCID 0000-0001-6818-6065
William S HarrisFatty Acid Research Institute, Sioux Falls, SD (N.R.A., J.H.O.K., N.L.T., W.S.H.).ORCID 0000-0003-3042-9353

Funding

Multidisciplinary Training Program in Cardiovascular EpidemiologyT32HL125232 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Matthew G. Nayor, Vanessa Xanthakis · 2016 to 2026
$5.0M
The Age-Related Eye Disease Study 2 (AREDS2)ZIAEY000485 · NEI · NATIONAL EYE INSTITUTE · PI CHEW, EMILY Y · 2009 to 2015
$990k
Intramural NIH HHS Z99 EY999999Intramural NIH HHS ZIA EY000485NHLBI NIH HHS T32 HL125232
6 · The paper itself

Abstract

backgroundRecent meta-analyses of randomized controlled trials have raised concerns that treatment with omega-3 fatty acids may increase the risk of atrial fibrillation (AF). However, these meta-analyses included at most 8 trials. The aim of this current meta-analysis was to expand the search by including other eligible omega-3 randomized controlled trials with AF incidence data, incorporating both published and unpublished data.

methodsEligible studies were randomized controlled trials investigating daily doses of ≥500 mg/d of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Additional inclusion criteria included ≥12 months of treatment with EPA/DHA, participants ≥50 years of age, and, where possible, the absence of known AF/atrial flutter at baseline. The primary outcome was the occurrence of new-onset AF. Our primary hypothesis was that risk for AF would simultaneously depend on both omega-3 dose (above or below 1500 mg/d) and background cardiovascular disease risk status, and that their combined impact on AF risk would be synergistic.

resultsA total of 35 randomized controlled trials (37 data sets; n=114 592) were included in this meta-analysis. Only studies including patients at high-risk for cardiovascular disease who were treated with high-doses of EPA/DHA (>1500 mg/d) showed a statistically significant increase in AF risk with a pooled odds ratio (OR) of 1.43 (95% CI, 1.14-1.79) and an absolute risk difference of 0.8% (0.40%-1.1%). None of the other 3 groups showed statistically significant levels of AF risk (odds ratios, 1.07 [high risk-low dose], 1.06 [low risk-low dose], and 1.03 [low risk-high dose]).

conclusionsThis meta-analysis suggests that high-dose EPA/DHA treatment is associated with an increased risk of AF in patients at high cardiovascular disease risk, whereas low-dose EPA/DHA does not appear to increase AF risk, even in high-risk populations. Further prospective studies are needed to evaluate any potential increased risk of higher doses balanced against potential benefits.

Indexed as

Atrial FibrillationDocosahexaenoic AcidsEicosapentaenoic AcidFatty Acids, Omega-3HumansIncidenceMiddle AgedRandomized Controlled Trials as TopicRisk AssessmentRisk FactorsTreatment OutcomeDocosahexaenoic AcidsEicosapentaenoic AcidFatty Acids, Omega-3atrial fibrillationatrial flutterdocosahexaenoic acidseicosapentaenoic acidfatty acids, omega-3

Identifiers

PMID42517224
PMCPMC13489779

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.