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

• Published in: Stroke (1970) 2024-01, Vol.55 (1), p.50-58
• Main Authors: 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
• Format: Article
• Language: English
• Subjects: atrial fibrillation; cerebrovascular disease; Docosahexaenoic Acids; Eicosapentaenoic Acid; Fatty Acids, Omega-3; fish; fish oil; Hemorrhagic Stroke - epidemiology; Humans; Ischemic Stroke; Life Sciences; Prospective Studies; Risk Factors; Santé publique et épidémiologie; stroke; Stroke - epidemiology
• ISSN: 0039-2499; 1524-4628; 1524-4628
• DOI: 10.1161/STROKEAHA.123.044281

The effect of marine omega-3 PUFAs on risk of stroke remains unclear. 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. 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];