학술논문
Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies
Document Type
Academic Journal
Author
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 Sørensen; Schmidt, Erik Berg; Venø, Stine Krogh; Chien, Kuo-Liong; Chen, Yun-Yu (Amelia); Egert, Sarah; Feldreich, Tobias Rudholm; Ärnlöv, 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.; Risérus, Ulf; Lázaro, Iolanda; Samieri, Cecilia; Le Goff, Mélanie; 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
Source
Stroke. Jan 01, 2024 55(1):50-58
Subject
Language
English
ISSN
0039-2499
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.