U-shaped relationship between tissue docosahexaenoic acid and atrial fibrillation following cardiac surgery.

• Published in: European Journal of Clinical Nutrition
• Main Authors: Metcalf, R G, Skuladottir, G V, Indridason, O S, Sullivan, T R, Bjorgvinsdottir, L, Sanders, P, Arnar, D O, Gibson, R A, Heidarsdottir, R, Cleland, L G, Palsson, R, Farquharson, A L, Young, G D, James, M J
• Other Authors: Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia 2 Centre for Heart Rhythm Disorders, Discipline of Medicine, University of Adelaide, Adelaide, Australia. 21 Department of Physiology, School of Health Sciences, University of Iceland, Reykjavik, Iceland 2 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. 3Division of Nephrology, Internal Medicine Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 4Data Management and Analysis Centre, Discipline of Public Health, University of Adelaide, Adelaide, Australia. 51 Centre for Heart Rhythm Disorders, Discipline of Medicine, University of Adelaide, Adelaide, Australia 2 Cardiovascular Investigation Unit, Royal Adelaide Hospital, Adelaide, Australia. 61 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland 2 Division of Cardiology, Internal Medicine Services, Cardiovascular Research Center, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 7FOODplus Research Centre, School of Agriculture Food and Wine, University of Adelaide, Adelaide, Australia. 8Rheumatology Unit, Royal Adelaide Hospital, Adelaide, Australia. 91 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland 2 Division of Nephrology, Internal Medicine Services, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 10Centre for Heart Rhythm Disorders, Discipline of Medicine, University of Adelaide, Adelaide, Australia.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Nature Publishing Group 2014
• Subjects: Gáttatif; Hjartaaðgerðir; Ómega-3 fjölómettaðar fitusýrur; Fæðubótarefni; Lýsi; Unglingar; Fullorðnir; Adolescent; Adult; Atrial Fibrillation; Australia; Cardiac Surgical Procedures; Dietary Supplements; Docosahexaenoic Acids; Eicosapentaenoic Acid; Female; Fish Oils; Humans; Iceland; Incidence; Logistic Models; Male; Multivariate Analysis; Odds Ratio; Postoperative Care; Randomized Controlled Trials as Topic; Young Adult
• Online Access: http://hdl.handle.net/2336/325543; https://doi.org/10.1038/ejcn.2013.215

To access publisher's full text version of this article click on the hyperlink at the bottom of the page Randomised controlled trials (RCTs) evaluating the effect of fish oil supplementation on postoperative atrial fibrillation (POAF) following cardiac surgery have produced mixed results. In this study, we examined relationships between levels of red blood cell (RBC) n-3 long-chain polyunsaturated fatty acids (LC-PUFAs) and the incidence of POAF. We used combined data (n=355) from RCTs conducted in Australia and Iceland. The primary end point was defined as POAF lasting >10 min in the first 6 days following surgery. The odds ratios (ORs) for POAF were compared between quintiles of preoperative RBC n-3 LC-PUFA levels by multivariable logistic regression. Subjects with RBC docosahexaenoic acid (DHA) in the fourth quintile, comprising a RBC DHA range of 7.0-7.9%, had the lowest incidence of POAF. Subjects in the lowest and highest quintiles had significantly higher risk of developing POAF compared with those in the fourth quintile (OR=2.36: 95% CI; 1.07-5.24 and OR=2.45: 95% CI; 1.16-5.17, respectively). There was no association between RBC eicosapentaenoic acid levels and POAF incidence. The results suggest a 'U-shaped' relationship between RBC DHA levels and POAF incidence. The possibility of increased risk of POAF at high levels of DHA suggests an upper limit for n-3 LC-PUFAs in certain conditions. National Health and Medical Research Council of Australia, Canberra, Australia/399333 Icelandic Centre for Research (RANNIS)/080411021 University of Iceland Research Fund Landspitali - The National University Hospital of Iceland Research Fund National Heart Foundation of Australia, Melbourne, Australia National Health and Medical Research Council of Australia, Canberra, Australia