Fish oil and postoperative atrial fibrillation: The omega-3 fatty acids for prevention of post-operative atrial fibrillation (OPERA) randomized trial

JAMA

Volumn 308, Issue 19, 2012, Pages 2001-2011

  Mozaffarian, Dariush ^a,b,c   Marchioli, Roberto ^d   Macchia, Alejandro ^e   Silletta, Maria G ^d   Ferrazzi, Paolo ^f   Gardner, Timothy J ^g   Latini, Roberto ^h   Libby, Peter ^a,b   Lombardi, Federico ⁱ   O'Gara, Patrick T ^a,b   Page, Richard L ^j   Tavazzi, Luigi ^k   Tognoni, Gianni ^d   Santini, Massimo ^l   Albert, Christine M ^b   Maggioni, Aldo P ^m   Murray, Katherine T ⁿ   Harris, Bill ^o   Saffitz, Jeffery E ^b   Siscovick, David ^p   Stein, Phyllis ^q   Corradi, Domenico ^r   Masson, Serge ^h   Brown, Nancy J ⁿ   Ely, E Wesley ⁿ   Jackson, James C ⁿ   Shintani, Ayumi ⁿ   Milne, Ginger L ⁿ   Song, Xiaoling ^s   Sellke, Frank W ^t   Pioggiarella, Raffaella ^d   Marfisi, Lorenzo ^d   King, Sarah L ^c   Mills, Kristen E ^c   Ogunleye, Adeyemi ^c   Schelling, Namasha H ^c   Wu, Jason ^c   Simon, Caterina ^f   Iascone, Maria ^f   Sinatra, Riccardo ^u   Benedetto, Umberto ^u   Dreas, Lorella ^v   Aleksova, Aneta ^v   Rinaldi, Mauro ^w   Salizzoni, Stefano ^w   Marchetto, Giovanni ^w   Lamarra, Mauro ^x   Pagliaro, Marco ^x   Jori, Maria Cristina ^x   Dozza, Luca ^x   Calvi, Simone ^x   Casabona, Riccardo ^y   Zingarelli, Edoardo ^y   Flocco, Roberto ^y   Eusebio, Alessandro ^z   Raffa, Giuseppe ^z   Tarelli, Giuseppe ^z   Parolari, Alessandro ^aa   Cavallotti, Laura ^aa   Miyasoedova, Veronica ^aa   Laguzzi, Federica ^aa   Gregorini, Renato ^x   Mangia, Federica ^x   Gazzoli, Fabrizio ^ab   Raviola, Eliana ^w,ab   Viganò, Mario ^ab   Livi, Ugolino ^ac   Pompei, Esmeralda ^ac   Salvador, Loris ^ad   Lamascese, Nicola ^ad   Bilotta, Massimo ^ad   Martinelli, Luigi ^ae   Cannata, Aldo ^ae   Byrne, John ⁿ   Leacche, Marzia ⁿ   Petracek, Michael R ⁿ   Ball, Stephen K ⁿ   Jessen, Michael E ^af   Weyant, Mary ^af   Damiano, Ralph J ^q   Singh, Arun K ^t   McDonald, Mary Jane ^t   Bolman, R Morton ^b   Conboy, Debra A ^b   Burgess, Anne ^b   Puskas, John D ^ag   Vander Woude, John ^o   Bell, Maria C ^o   Sethi, Gulshan ^ah   Lee, Daniel C ^ai   Favaloro, Roberto Rene ^aj   Hershson, Alejandro Ruben ^aj   Figal, Julio Cesar ^aj   Domenech, Alberto ^ak   Halac, Marcelo ^ak   Nicolosi, Liliana Noemi ^al   Morós, Claudio Gabriel ^al   Del Carmen Rubio, Maria ^al   Suárez, Richard Fuentes ^al   Cacheda, Horacio ^am   Casal, Juan Pablo ^am   Medrano, Juan Carlos ^an   Cucurell, Maria Carla ^an   Scattini, Florencia ^an   Nojek, Carlos ^ao   Camporrotondo, Mariano ^ao   Herrington, David M ^ap   Brooks, Maria Mori ^aq   De Caterina, Raffaele ^ar   Gillinov, Marc ^as   Padeletti, Luigi ^at   Pellegrini, Fabio ^d   Rothschild, Barbra Bluestone ^au   Rubinstein, Fernando ^av   Diep, Pho Q ^s   Guzman, Junitta B ^s   Palmarini, Laura ^d   Sacchetti, Stefania ^d   Flamminio, Anna V ^d   Marfisi, Rosamaria ^d   Scarano, Marco ^d   Afshin, Ashkan ^c   Huang, Hongyan ^c   Otite, Fadar ^c   Ambrosio, Marilisa ^f   Lincesso, Annarita ^f   Pezzoli, Laura ^f   Anzini, Marco ^v   Carriere, Cosimo ^v   Belfiore, Rita ^v   Fortunato, Guglielmo ^w   Pellegrini, Augusto ^w   Reale, Vincenzo ^w   Sorrentino, Paolo ^w   Schiavina, Giulia ^x   Negrosanti, Monica ^x   Ravenni, Giacomo ^y   Moro, Franco ^aa   Brambilla, Marta ^aa   Nava, Cristina ^aa   Giroli, Monica ^aa   Daprati, Andrea ^aa   Gennari, Marco ^aa   Cusihuaman, Dennis Ezra Puma ^aa   Spagnolo, Barbara ^x   Francia, Michela ^x   Stanca, Maurizio ^x   Paris, Marco ^ab   Berwick, Daniele ^ab   Lusona, Bruno ^ab   Castiglione, Nicoletta ^ab   De Biasio, Marzia ^ac   Daffarra, Cristian ^ac   Ahmad, Rashid ⁿ   Meisch, Carol A ⁿ   Maltais, Simon ⁿ   Balaguer, Jorge ⁿ   Donahue, Tamara ^q   Guyton, Robert A ^ag   Thourani, Vinod ^ag   Halkos, Michael ^ag   Lattouf, Omar ^ag   Baio, Kim T ^ag   Levine, Samatha R ^ag   Pitts, Zachary E ^ag   Janssen, Kathy ^o   Ruhlman, Marilyn ^o   Sharp, Sarah ^ah   Pang, Kristy ^ai   Mungo, Matías Nicolás ^aj   Servián, Ada Liz ^aj   Battellini, Roberto ^ak   Marenchino, Ricardo ^ak   Kotowicz, Vadim ^ak   Cesáreo, Vicente ^ak   Sánchez, Ricardo ^ak   Romero, Veronica ^ak   Avila, Silvia ^ak   Donnini, Fabian ^al   Biancospino, Leticia ^al   Laurino, Romina ^am   Portalea, Rodolfo ^am   more..

^a Division of Cardiovascular Medicine   (United States)

^b HARVARD MEDICAL SCHOOL   (United States)

^c HARVARD SCHOOL OF PUBLIC HEALTH   (United States)

^d Laboratory of Clinical Epidemiology of Cardiovascular Disease ^*  (Italy)

^e GESICA   (Argentina)

^f OSPEDALI RIUNITI   (Italy)

^g CHRISTIANA CARE HEALTH SYSTEM   (United States)

^h MARIO NEGRI INSTITUTE FOR PHARMACOLOGICAL RESEARCH   (Italy)

ⁱ UNIVERSITY OF MILAN   (Italy)

^j UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE AND PUBLIC HEALTH   (United States)

^k MARIA CECILIA HOSPITAL   (Italy)

^l SAN FILIPPO NERI HOSPITAL   (Italy)

^m ANMCO RESEARCH CENTER   (Italy)

ⁿ VANDERBILT UNIVERSITY SCHOOL OF MEDICINE   (United States)

^o UNIVERSITY OF SOUTH DAKOTA   (United States)

^p UNIVERSITY OF WASHINGTON   (United States)

^q WASHINGTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

^r UNIVERSITY OF PARMA   (Italy)

^s Fred Hutchinson Cancer Research Center   (United States)

^t RHODE ISLAND HOSPITAL   (United States)

^u SAPIENZA UNIVERSITY OF ROME   (Italy)

^v UNIVERSITY OF TRIESTE   (Italy)

^w UNIVERSITY OF TURIN   (Italy)

^x Research Ettore Sansavini Health Science Foundation   (Italy)

^y MAURIZIANO HOSPITAL   (Italy)

^z HUMANITAS CLINICAL AND RESEARCH CENTER   (Italy)

^aa CENTRO CARDIOLOGICO MONZINO   (Italy)

^ab FONDAZIONE IRCCS POLICLINICO SAN MATTEO   (Italy)

^ac SANTA MARIA DELLA MISERICORDIA UNIVERSITY HOSPITAL   (Italy)

^ad SAN BORTOLO HOSPITAL   (Italy)

^ae OSPEDALE NIGUARDA CA GRANDA   (Italy)

^af UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

^ag EMORY UNIVERSITY SCHOOL OF MEDICINE   (United States)

^ah UNIVERSITY OF ARIZONA   (United States)

^ai SUNY DOWNSTATE MEDICAL CENTER   (United States)

^aj HOSPITAL UNIVERSITARIO FUNDACIÓN FAVALORO   (Argentina)

^ak HOSPITAL ITALIANO DE BUENOS AIRES   (Argentina)

^al HOSPITAL ESPAÑOL   (Argentina)

^am Instituto de Cardiologia de Corrientes   (Argentina)

^an Clinica y Maternidadde Suizo   (Argentina)

^ao Section of Pediatric Cardiology   (Argentina)

^ap WAKE FOREST SCHOOL OF MEDICINE   (United States)

^aq UNIVERSITY OF PITTSBURGH   (United States)

^ar UNIVERSITY OF CHIETI   (Italy)

^as LERNER RESEARCH INSTITUTE   (United States)

^at UNIVERSITY OF FLORENCE   (Italy)

^au UNIVERSITY OF NORTH CAROLINA   (United States)

^av INSTITUTE FOR CLINICAL EFFECTIVENESS AND HEALTH POLICY   (Argentina)

more..

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ALDOSTERONE ANTAGONIST; AMIODARONE; ANGIOTENSIN RECEPTOR ANTAGONIST; ANTICOAGULANT AGENT; ANTITHROMBOCYTIC AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; CLOPIDOGREL; DIGITALIS; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DISOPYRAMIDE; DOCOSAHEXAENOIC ACID; FISH OIL; FLECAINIDE; HEPARIN; HYDROXYMETHYLGLUTARYL COENZYME A REDUCTASE INHIBITOR; LOOP DIURETIC AGENT; OMEGA 3 FATTY ACID; PLACEBO; PROPAFENONE; QUINIDINE; SOTALOL; TICLOPIDINE; WARFARIN;

ADULT; AGED; ARGENTINA; ARTICLE; BLEEDING; CARDIOVASCULAR MORTALITY; CARDIOVASCULAR RISK; CARDIOVERSION; CONTROLLED STUDY; DIET SUPPLEMENTATION; DOUBLE BLIND PROCEDURE; DRUG EFFICACY; DRUG TOLERABILITY; FEMALE; HEALTH CARE UTILIZATION; HEART ATRIUM FIBRILLATION; HEART SURGERY; HUMAN; ITALY; LOADING DRUG DOSE; MAJOR CLINICAL STUDY; MALE; MULTICENTER STUDY; OUTCOME ASSESSMENT; POSTOPERATIVE COMPLICATION; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; SINUS RHYTHM; SURGICAL PATIENT; UNITED STATES;

EID: 84869170925     PISSN: 00987484     EISSN: 15383598     Source Type: Journal    
DOI: 10.1001/jama.2012.28733     Document Type: Article

References (44)

1. Hogue CW Jr, Creswell LL, Gutterman DD, Fleisher LA; American College of Chest Physicians. Epidemiology, mechanisms, and risks: American College of Chest Physicians guidelines for the prevention and management of postoperative atrial fibrillation after cardiac surgery. Chest. 2005;128(2)(suppl):9S-16S.
2. Mitchell LB; CCS Atrial Fibrillation Guidelines Committee. Canadian Cardiovascular Society atrial fibrillation guidelines 2010: prevention and treatment of atrial fibrillation following cardiac surgery. Can J Cardiol. 2011;27(1):91-97.
3. Mariscalco G, Klersy C, Zanobini M, et al. Atrial fibrillation after isolated coronary surgery affects late survival. Circulation. 2008;118(16):1612-1618.
4. Mathew JP, Parks R, Savino JS, et al; MultiCenter Study of Perioperative Ischemia Research Group. Atrial fibrillation following coronary artery bypass graft surgery: predictors, outcomes, and resource utilization. JAMA. 1996;276(4):300-306.
5. Auer J, Weber T, Berent R, Ng CK, Lamm G, Eber B. Postoperative atrial fibrillation independently predicts prolongation of hospital stay after cardiac surgery. J Cardiovasc Surg (Torino). 2005;46(6):583-588.
6. Hravnak M, Hoffman LA, Saul MI, Zullo TG, Whitman GR. Resource utilization related to atrial fibrillation after coronary artery bypass grafting. Am J Crit Care. 2002;11(3):228-238.
7. Burgess DC, Kilborn MJ, Keech AC. Interventions for prevention of post-operative atrial fibrillation and its complications after cardiac surgery: a meta-analysis. Eur Heart J. 2006;27(23):2846-2857.
8. Mozaffarian D, Wu JH. Omega-3 fatty acids and cardiovascular disease: effects on risk factors, molecular pathways, and clinical events. J Am Coll Cardiol. 2011;58(20):2047-2067.
9. Rizos EC, Ntzani EE, Bika E, Kostapanos MS, Elisaf MS. Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. JAMA. 2012;308(10):1024-1033.
10. Jahangiri A, Leifert WR, Patten GS, McMurchie EJ. Termination of asynchronous contractile activity in rat atrial myocytes by n-3 polyunsaturated fatty acids. Mol Cell Biochem. 2000;206(1-2):33-41.
11. Kumar S, Sutherland F, Rosso R, et al. Effects of chronic omega-3 polyunsaturated fatty acid supplementation on human atrial electrophysiology. Heart Rhythm. 2011;8(4):562-568.
12. Kumar S, Sutherland F, Teh AW, et al. Effects of chronic omega-3 polyunsaturated fatty acid supplementation on human pulmonary vein and left atrial electrophysiology in paroxysmal atrial fibrillation. Am J Cardiol. 2011;108(4):531-535.
13. Khawaja O, Gaziano JM, Djoussé L. A metaanalysis of omega-3 fatty acids and incidence of atrial fibrillation. J Am Coll Nutr. 2012;31(1):4-13.
14. Mozaffarian D, Marchioli R, Gardner T, et al. The ω-3 Fatty Acids for Prevention of Post-operative Atrial Fibrillation (OPERA) trial - rationale and design. Am Heart J. 2011;162(1):56-63, e3.
15. Mozaffarian D, Psaty BM, Rimm EB, et al. Fish intake and risk of incident atrial fibrillation. Circulation. 2004;110(4):368-373.
16. Calò L, Bianconi L, Colivicchi F, et al. N-3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial. J Am Coll Cardiol. 2005;45(10):1723-1728.
17. Harris WS. Effects of n-3 fatty acids on human lipoprotein metabolism. In: Frolich JC, von Schacky C, eds. Fish, Fish Oil, and Human Health. Germering, Germany: Zuckschwerdt-Verlag; 1992:88-97.
18. Camm AJ, Kirchhof P, Lip GY, et al; European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010;31(19):2369- 2429.
19. Wu JH, Lemaitre RN, King IB, et al. Association of plasma phospholipid long-chain ω-3 fatty acids with incident atrial fibrillation in older adults: the Cardiovascular Health Study. Circulation. 2012;125(9):1084-1093.
20. Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. European System for Cardiac Operative Risk Evaluation (EuroSCORE). Eur J Cardiothorac Surg. 1999;16(1):9-13.
21. Roques F, Michel P, Goldstone AR, Nashef SA. The logistic EuroSCORE. Eur Heart J. 2003;24(9):881-882.
22. Mozaffarian D, Rimm EB. Fish intake, contaminants, and human health: evaluating the risks and the benefits. JAMA. 2006;296(15):1885-1899.
23. McLennan PL. Myocardial membrane fatty acids and the antiarrhythmic actions of dietary fish oil in animal models. Lipids. 2001;36(suppl):S111-S114.
24. Leaf A, Kang JX, Xiao YF, Billman GE. Clinical prevention of sudden cardiac death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Circulation. 2003;107(21):2646-2652.
25. Brouwer IA, Raitt MH, Dullemeijer C, et al. Effect of fish oil on ventricular tachyarrhythmia in three studies in patients with implantable cardioverter defibrillators. Eur Heart J. 2009;30(7):820-826.
26. Kowey PR, Reiffel JA, Ellenbogen KA, Naccarelli GV, Pratt CM. Efficacy and safety of prescription omega-3 fatty acids for the prevention of recurrent symptomatic atrial fibrillation: a randomized controlled trial. JAMA. 2010;304(21):2363-2372.
27. Nodari S, Triggiani M, Campia U, et al. n-3 polyunsaturated fatty acids in the prevention of atrial fibrillation recurrences after electrical cardioversion: a prospective, randomized study. Circulation. 2011;124(10):1100-1106.
28. Bianconi L, Calò L, Mennuni M, et al. n-3 polyunsaturated fatty acids for the prevention of arrhythmia recurrence after electrical cardioversion of chronic persistent atrial fibrillation: a randomized, doubleblind, multicentre study. Europace. 2011;13(2):174-181.
29. Ozaydin M, Erdoǧan D, Tayyar S, et al. N-3 polyunsaturated fatty acids administration does not reduce the recurrence rates of atrial fibrillation and inflammation after electrical cardioversion: a prospective randomized study. Anadolu Kardiyol Derg. 2011;11(4):305-309.
30. Kumar S, Sutherland F, Morton JB, et al. Longterm omega-3 polyunsaturated fatty acid supplementation reduces the recurrence of persistent atrial fibrillation after electrical cardioversion. Heart Rhythm. 2012;9(4):483-491.
31. Finzi AA, Latini R, Barlera S, et al. Effects of n-3 polyunsaturated fatty acids on malignant ventricular arrhythmias in patients with chronic heart failure and implantable cardioverter-defibrillators: a substudy of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Insufficienza Cardiaca (GISSI-HF) trial. Am Heart J. 2011;161(2):338-343, e1.
32. Burr ML, Fehily AM, Gilbert JF, et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: Diet And Reinfarction Trial (DART). Lancet. 1989;2(8666):757-761.
33. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet. 1999;354(9177):447-455.
34. Marchioli R, Barzi F, Bomba E, et al; GISSI-Prevenzione Investigators. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. Circulation. 2002;105(16):1897-1903.
35. Heidt MC, Vician M, Stracke SK, et al. Beneficial effects of intravenously administered n-3 fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a prospective randomized study. Thorac Cardiovasc Surg. 2009;57(5):276-280.
36. Saravanan P, Bridgewater B, West AL, O'Neill SC, Calder PC, Davidson NC. Omega-3 fatty acid supplementation does not reduce risk of atrial fibrillation after coronary artery bypass surgery: a randomized, double-blind, placebo-controlled clinical trial. Circ Arrhythm Electrophysiol. 2010;3(1):46-53.
37. Heidarsdottir R, Arnar DO, Skuladottir GV, et al. Does treatment with n-3 polyunsaturated fatty acids prevent atrial fibrillation after open heart surgery? Europace. 2010;12(3):356-363.
38. Sorice M, Tritto FP, Sordelli C, Gregorio R, Piazza L. N-3 polyunsaturated fatty acids reduces postoperative atrial fibrillation incidence in patients undergoing "on-pump" coronary artery bypass graft surgery. Monaldi Arch Chest Dis. 2011;76(2):93-98.
39. Farquharson AL, Metcalf RG, Sanders P, et al. Effect of dietary fish oil on atrial fibrillation after cardiac surgery. Am J Cardiol. 2011;108(6):851-856.
40. Sandesara CM, Chung MK, Van Wagoner DR, et al. A randomized, placebo-controlled trial of omega-3 fatty acids for inhibition of supraventricular arrhythmias after cardiac surgery: the FISH trial. J Am Heart Assoc. 2012;1:e000547.
41. Thies F, Garry JM, Yaqoob P, et al. Association of n-3 polyunsaturated fatty acids with stability of atherosclerotic plaques: a randomised controlled trial. Lancet. 2003;361(9356):477-485.
42. Rapp JH, Connor WE, Lin DS, Porter JM. Dietary eicosapentaenoic acid and docosahexaenoic acid from fish oil: their incorporation into advanced human atherosclerotic plaques. Arterioscler Thromb. 1991;11(4):903-911.
43. Reis GJ, Boucher TM, Sipperly ME, et al. Randomised trial of fish oil for prevention of restenosis after coronary angioplasty. Lancet. 1989;2(8656):177-181.
44. Eritsland J, Arnesen H, Seljeflot I, Kierulf P. Longterm effects of n-3 polyunsaturated fatty acids on haemostatic variables and bleeding episodes in patients with coronary artery disease. Blood Coagul Fibrinolysis. 1995;6(1):17-22.