Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies-Reference-Cited by-同舟云学术

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

Published:2024-01 Issue:1 Volume:55 Page:50-58
ISSN:0039-2499
Container-title:Stroke
language:en
Short-container-title:Stroke

Author:

O’Keefe James H.¹^ORCID,Tintle Nathan L.²,Harris William S.²³,O’Keefe Evan L.¹^ORCID,Sala-Vila Aleix²⁴,Attia John⁵^ORCID,Garg G. Manohar⁵^ORCID,Hure Alexis⁵^ORCID,Bork Christian Sørensen⁶^ORCID,Schmidt Erik Berg⁷^ORCID,Venø Stine Krogh⁸,Chien Kuo-Liong⁹^ORCID,Chen Yun-Yu (Amelia)¹⁰^ORCID,Egert Sarah¹¹,Feldreich Tobias Rudholm¹²,Ärnlöv Johan¹³^ORCID,Lind Lars¹⁴^ORCID,Forouhi Nita G.¹⁵^ORCID,Geleijnse Johanna M.¹⁶^ORCID,Pertiwi Kamalita¹⁶^ORCID,Imamura Fumiaki¹⁵^ORCID,de Mello Laaksonen Vanessa¹⁷^ORCID,Uusitupa W. Matti¹⁷^ORCID,Tuomilehto Jaakko¹⁷^ORCID,Laakso Markku¹⁸^ORCID,Lankinen Maria Anneli¹⁷^ORCID,Laurin Danielle¹⁹^ORCID,Carmichael Pierre-Hugues¹⁹^ORCID,Lindsay Joan²⁰,Leander Karin²¹^ORCID,Laguzzi Federica²¹^ORCID,Swenson Brenton R.²²^ORCID,Longstreth William T.²³,Manson JoAnn E.²⁴^ORCID,Mora Samia²⁴^ORCID,Cook Nancy R.²⁴^ORCID,Marklund Matti²⁵²⁶²⁷^ORCID,Melo van Lent Debora²⁸^ORCID,Murphy Rachel²⁹^ORCID,Gudnason Vilmundur³⁰^ORCID,Ninomiya Toshihara³¹,Hirakawa Yoichiro³¹,Qian Frank³²^ORCID,Sun Qi³³^ORCID,Hu Frank³³^ORCID,Ardisson Korat Andres V.³⁴^ORCID,Risérus Ulf³⁵^ORCID,Lázaro Iolanda⁴^ORCID,Samieri Cecilia³⁶,Le Goff Mélanie³⁶^ORCID,Helmer Catherine³⁶,Steur Marinka³⁷^ORCID,Voortman Trudy³⁷^ORCID,Ikram M. Kamran³⁷^ORCID,Tanaka Toshiko³⁸,Das Jayanta K.³⁹,Ferrucci Luigi³⁸^ORCID,Bandinelli Stefania⁴⁰,Tsai Michael⁴¹^ORCID,Guan Weihua⁴²^ORCID,Garg Parveen⁴³^ORCID,Verschuren W.M. Monique⁴⁴⁴⁵^ORCID,Boer Jolanda M.A.⁴⁶^ORCID,Biokstra Anneke⁴⁶^ORCID,Virtanen Jyrki¹⁷^ORCID,Wagner Michael⁴⁷^ORCID,Westra Jason²,Albuisson Luc⁴⁸,Yamagishi Kazumasa⁴⁹^ORCID,Siscovick David S.⁵⁰^ORCID,Lemaitre Rozenn N.⁵¹^ORCID,Mozaffarian Dariush⁵²^ORCID

Affiliation:

1. Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City (J.H.O., E.L.O.).

2. Fatty Acid Research Institute (N.L.T., W.S.H., A.S.-V., J.W.), Sioux Falls, SD.

3. University of South Dakota (W.S.H.), Sioux Falls, SD.

4. Hospital del Mar Medical Research Institute, Barcelona, Spain (A.S.-V., I.L.).

5. The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia (J. Attia, G.M.G., A.H.).

6. Department of Cardiology, Aalborg University Hospital, Denmark (C.S.B.)

7. Department of Clinical Medicine (E.B.S.), Aalborg University Hospital, Denmark.

8. Department of Clinical Biochemistry (S.K.V.), Aalborg University Hospital, Denmark.

9. National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (K.-L.C.).

10. Department of Medical Research, Taichung Veterans General Hospital, Taiwan (Y.-Y.C.).

11. Institute of Nutrition and Food Sciences and Nutritional Physiology, University of Bonn, Germany (S.E.).

12. Dalarna University, School of Health and Welfare, Falun, Sweden (T.R.F.).

13. Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Solna, Sweden (J. Ärnlöv).

14. Department of Medical Sciences Cardiovascular Epidemiology, Uppsala University, Sweden (L.L.).

15. MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, United Kingdom (N.G.F., F.I.).

16. Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands (J.M.G., K.P.).

17. Institute of Public Health and Clinical Nutrition (V.d.M.L., W.M.U., J.T., M.A.L., J.V.), School of Medicine, University of Eastern Finland, Kuopio, Finland.

18. Department of Internal Medicine (M.L.), School of Medicine, University of Eastern Finland, Kuopio, Finland.

19. CHU de Québec-Université Laval and VITAM Research Centers, Centre d’Excellence sur le Vieillissement de Québec, Canada (D.L., P.-H.C.).

20. School of Epidemiology and Public Health, University of Ottawa, Canada (J.L.).

21. Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden (K.L., F.L.).

22. Cardiovascular Health Research Unit (B.R.S.), University of Washington, Seattle.

23. Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle.

24. Department of Medicine, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA (J.E.M., S.M., N.R.C.).

25. The George Institute for Global Health, University of New South Wales, Newtown, Australia (M.M.).

26. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (M.M.).

27. Department of Public Health and Caring Sciences, Uppsala University, Sweden (M.M.).

28. Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas, San Antonio (D.M.v.L.).

29. Cancer Control Research, British Columbia Cancer, School of Population and Public Health, University of British Columbia, Vancouver, Canada (R.M.).

30. Icelandic Heart Institute, Kopavogur, Iceland (V.G.).

31. Department of Epidemiology and Public Health and Center for Cohort Studies, Kyushu University, Fukouka, Japan (T.N., Y.H.).

32. Harvard Medical School, T.H. Chan School of Public Health and Beth Deaconess Medical Center, Boston, MA (F.Q.).

33. Harvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women’s Hospital, Boston, MA (Q.S., F.H.).

34. USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA (A.V.A.K.).

35. Department of Public Health and Caring Sciences Clinical Nutrition and Metabolism Unit, Uppsala University, Sweden (U.R.).

36. Bordeaux Population Health Research Centre, University of Bordeaux, France (C.S., M.L.G., C.H.).

37. Department of Epidemiology, University Medical Center Rotterdam, the Netherlands (M.S., T.V., M.K.I.).

38. National Institutes of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD (T.T., L.F.).

39. Tata Medical Center, Kolkata, India (J.K.D.).

40. Azienda Sanitaria Firenze, Geriatric Unit, Florence, Italy (S.B.).

41. Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.T.).

42. Division of Biostatistics, University of Minnesota, Minneapolis (W.G.).

43. Department of Medicine, Cardiology, University of Southern California, Los Angeles (P.G.).

44. National Institute for Public Health and the Environment Bilthoven, the Netherlands (W.M.M.V.).

45. Julius Center for Health Sciences and Primary Care and Centre for Nutrition, Prevention and Health Services, Utrecht, the Netherlands (W.M.M.V.).

46. National Institute for Public Health and the Environment Bilthoven, the Netherlands (J.M.A.B., A.B.).

47. Departments of Neurodegenerative Diseases and Geriatric Psychiatry and German Center for Neurodegenerative Diseases, University Hospital, Bonn, Germany (M.W.).

48. University of Denver, CO (L.A.).

49. Department of Public Health Medicine, University of Tsukubu, Japan (K.Y.).

50. Department of Epidemiology, New York Academy of Medicine (D.S.S.).

51. Department of Medicine, University of Washington, Seattle (R.N.L.).

52. Division of Cardiology, Tufts University, Boston, MA (D.M.).

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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference80 articles.

1. Global Burden of Stroke

2. EICOSAPENTAENOIC ACID AND PREVENTION OF THROMBOSIS AND ATHEROSCLEROSIS?

3. Explaining the Recent Fish Oil Trial “Failures”

4. Sea Change for Marine Omega-3s

5. BMI Affects the Relationship between Long Chain N-3 Polyunsaturated Fatty Acid Intake and Stroke Risk: a Meta-Analysis

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