# Omega-3 Fatty Acid Supplementation Does Not Reduce Mortality or Cardiovascular Events in Patients with or at High Risk of Diabetes

 

 

      DynaMed Weekly Update - Volume 7, Issue 32 

[Read the complete Weekly Update/earn CME credit](https://dynamed.antidotecme.com/)

Evidence for the effect of omega-3 fatty acids on cardiovascular risk has been inconsistent. While some systematic reviews have found little or no evidence that dietary or supplementary omega-3 fatty acid intake alters the risk of death or cardiovascular events in primary or secondary prevention ([Cochrane Database Syst Rev 2004 Oct 18;(4):CD003177](http://www.ncbi.nlm.nih.gov/pubmed?term=15495044%5buid%5d%20AND%20CD003177%5bpg%5d), [Arch Intern Med 2012 Apr 9 early online](http://www.ncbi.nlm.nih.gov/pubmed/22493407?dopt=Abstract&holding=caugamlib)), others have shown some benefit for cardiac mortality ([BMJ 2008 Dec 23;337:a2931](http://www.ncbi.nlm.nih.gov/pubmed/19106137?dopt=Abstract&holding=caugamlib), [Ann Med 2009;41(4):301](http://www.ncbi.nlm.nih.gov/pubmed/19148838?dopt=Abstract&holding=caugamlib)). The recently reported ORIGIN trial examined the effects of supplementation in 12,611 patients with impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes.

Patients > 50 years old (mean age 64 years, 88% with diabetes) were randomized to omega-3 fatty acids 1 g orally once daily (Omacor capsule, sold in United States as Lovaza) vs. placebo. All patients had preexisting cardiovascular disease (myocardial infarction, stroke, or revascularization in 59%) or cardiovascular risk factors at baseline. Patients were also randomized to open-label insulin glargine vs. standard care (with results reported in a companion publication). These groups were pooled for the primary analysis of the effects of omega-3 supplementation.

At median follow-up of 6.2 years, there were no significant differences between groups in cardiovascular mortality (9.1% vs. 9.3%) or all-cause mortality (15.1% vs. 15.4%) ([level 1 \[likely reliable\] evidence](http://dynamed.ebscohost.com/content/LOE)). There were also no significant differences in fatal and nonfatal myocardial infarction, fatal and nonfatal stroke, heart failure-related hospitalization, or revascularization procedures. Omega-3 supplementation was associated with significant reduction in triglyceride levels (p< 0.001), but had no significant effect on other lipid levels. In subgroup analyses, supplementation had no significant effect on cardiovascular mortality in either the insulin glargine or standard care groups ([N Engl J Med 2012 Jul 26;367(4):309](http://www.ncbi.nlm.nih.gov/pubmed/22686415?dopt=Abstract)).

For more information, see the [Omega-3-acid Ethyl Esters](http://search.ebscohost.com/login.aspx?direct=true&db=dme&AN=233003&site=dynamed-live&scope=site), [Diabetes alternative treatments](http://search.ebscohost.com/login.aspx?direct=true&db=dme&AN=271541&site=dynamed-live&scope=site), and [Dietary recommendations for cardiovascular disease prevention](http://search.ebscohost.com/login.aspx?direct=true&db=dme&AN=115449&site=dynamed-live&scope=site) topics in DynaMed.