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

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

Edité par CCSD ; American Heart Association -

International audience. 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.

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