Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies

James H O'Keefe*, Nathan L Tintle, William S Harris, Evan L O'Keefe, Aleix Sala-Vila, John Attia, G Manohar Garg, Alexis Hure, Christian Sørensen Bork, Erik Berg Schmidt, Stine Krogh Venø, Kuo-Liong Chien, Yun-Yu Amelia Chen, Sarah Egert, Tobias Rudholm Feldreich, Johan Ärnlöv, Lars Lind, Nita G Forouhi, Johanna M Geleijnse, Kamalita PertiwiFumiaki Imamura, Vanessa de Mello Laaksonen, W Matti Uusitupa, Jaakko Tuomilehto, Markku Laakso, Maria Anneli Lankinen, Danielle Laurin, Pierre-Hugues Carmichael, Joan Lindsay, Karin Leander, Federica Laguzzi, Brenton R Swenson, William T Longstreth, JoAnn E Manson, Samia Mora, Nancy R Cook, Matti Marklund, Debora Melo van Lent, Rachel Murphy, Vilmundur Gudnason, Toshihara Ninomiya, Yoichiro Hirakawa, Frank Qian, Qi Sun, Frank Hu, Andres V Ardisson Korat, Ulf Risérus, Iolanda Lázaro, Cecilia Samieri, Mélanie Le Goff, Catherine Helmer, Marinka Steur, Trudy Voortman, M Kamran Ikram, Toshiko Tanaka, Jayanta K Das, Luigi Ferrucci, Stefania Bandinelli, Michael Tsai, Weihua Guan, Parveen Garg, W M Monique Verschuren, Jolanda M A Boer, Anneke Biokstra, Jyrki Virtanen, Michael Wagner, Jason Westra, Luc Albuisson, Kazumasa Yamagishi, David S Siscovick, Rozenn N Lemaitre, Dariush Mozaffarian

*Kontaktforfatter

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

3 Citationer (Scopus)

Abstract

BACKGROUND: The effect of marine omega-3 PUFAs on risk of stroke remains unclear. METHODS: We investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual-level analysis using a prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome. RESULTS: Among 183 291 study participants, there were 10 561 total strokes, 8220 ischemic strokes, and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76-0.91]; P<0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74-0.91]; P<0.0001). For docosahexaenoic acid, comparing Q5 with Q1, there was a 12% lower incidence of total stroke (HR, 0.88 [CI, 0.81-0.96]; P=0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78-0.95]; P=0.0001). Neither eicosapentaenoic acid nor docosahexaenoic acid was associated with a risk for hemorrhagic stroke. These associations were not modified by either baseline history of AF or prevalent CVD. CONCLUSIONS: Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.

OriginalsprogEngelsk
TidsskriftStroke
Vol/bind55
Udgave nummer1
Sider (fra-til)50-58
Antal sider9
ISSN0039-2499
DOI
StatusUdgivet - jan. 2024

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