Effect of omega-three polyunsaturated fatty acids on inflammation, oxidative stress, and recurrence of atrial fibrillation

The efficacy of omega-3 polyunsaturated fatty acids (n-3 PUFAs) in preventing recurrence ofatrialfibrillation (AF) is controversial and their effects on inflammation and oxidative stressin this population are not known. This study examined the effects of high-dose marine n-3 PUFAs added to conventional therapy on the recurrence of AF and on markers of inflam-mation and oxidative stress. Patients with paroxysmal or persistent AF were randomized to n-3 PUFAs (4 g/day; n=126) or placebo (n=64) in a 2:1 ratio in a prospective, double-blind, placebo-controlled, parallel group study. The primary outcome was time to recur-rence of AF. Secondary outcomes were changes in biomarkers of inflammation (seruminterleukin [IL]-6, IL-8, IL-10, tissue necrosis factor alpha, monocyte chemoattractantprotein-1, and vascular endothelial growth factor), N-terminal-pro-brain-type natriureticpeptide, and oxidative stress (urinary F2-isoprostanes). AF recurred in 74 patients (58.7%) randomized to n-3 PUFAs and in 30 patients (46.9%) who received placebo; time to recur-rence of AF did not differ significantly in the 2 groups (hazard ratio 1.20; 95% confidenceinterval 0.76 to 1.90, adjusted p=0.438). Compared with placebo, n-3 PUFAs did not resultin clinically meaningful changes in concentrations of inflammatory markers, N-terminal-pro-brain-type natriuretic peptide or F2-isoprostanes. In conclusion, in patients withparoxysmal or persistent AF, treatment with n-3 PUFAs 4 g/day did not reduce the recur-rence of AF, nor was it associated with clinically important effects on concentrations ofmarkers of inflammation and oxidative stress.