Omega-3 and hemocompatibility-related adverse events

J Card Surg. 2020 Feb;35(2):405-412. doi: 10.1111/jocs.14384. Epub 2019 Dec 18.

Abstract

Background: Hemocompatibility-related clinical adverse events (HRAEs) are major causes of readmission in patients with left ventricular assist devices (LVADs). Omega-3 is an unsaturated fatty acid that possesses anti-inflammatory and antiangiogenic properties. We aimed to investigate the impact of omega-3 therapy on HRAEs during LVAD support.

Methods: Consecutive LVAD patients who were followed for 6 months were enrolled, and stratified by the use of omega-3. Freedom from any HRAEs and net burden of HRAEs, which was calculated by using a hemocompatibility score (using 4 escalating tiers of hierarchal severity to derive a total score for events), were compared between those with and without omega-3 therapy.

Results: Among 169 LVAD patients (57 years old and 124 males), 31 patients received 4 g/d of omega-3 therapy and 138 patients were in the control group. During the 6-month observational period, freedom from any HRAEs was 90% in the omega-3 group compared with 70% in the control group with a hazard ratio of 0.35 (95% confidence interval 0.11-0.87 and P = .042). The average hemocompatibility score in the omega-3 group was significantly lower compared with the control group (0.23 vs 0.91; P = .042), due to reduced Tier I scores (mild HRAE; P = .003) and Tier IIIB scores (severe HRAE; P < .001). The similar trends remained at propensity-matched populations.

Conclusions: Omega-3 therapy was associated with reduced HRAEs including both bleeding and thromboembolic events in LVAD patients.

Keywords: LVAD; bleeding; omega-3; stroke; unsaturated fatty acid.

MeSH terms

  • Fatty Acids, Omega-3 / administration & dosage*
  • Female
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / prevention & control*
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Stroke / etiology*
  • Stroke / prevention & control*
  • Thromboembolism / etiology*
  • Thromboembolism / prevention & control*

Substances

  • Fatty Acids, Omega-3