Associations of omega-3 fatty acids vs. fenofibrate with adverse cardiovascular outcomes in people with metabolic syndrome: propensity matched cohort study
- Authors
- Kim, Nam Hoon; Kim, Ji Yoon; Choi, Jimi; Kim, Sin Gon
- Issue Date
- Nov-2023
- Publisher
- OXFORD UNIV PRESS
- Keywords
- Fenofibrate; Omega-3 fatty acids; Metabolic syndrome; Cardiovascular diseases; Dyslipidaemias; Atherosclerosis
- Citation
- EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
- Indexed
- SCIE
- Journal Title
- EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65016
- DOI
- 10.1093/ehjcvp/pvad090
- ISSN
- 2055-6837
2055-6845
- Abstract
- Aims Omega-3 fatty acids and fenofibrates have shown some beneficial cardiovascular effects; however, their efficacy has not been compared. This study aimed to compare the effectiveness of currently available omega-3 fatty acids and fenofibrate for reducing major adverse cardiovascular events (MACE).Methods and results From a nationwide population-based cohort in South Korea (2008-2019), individuals with metabolic syndrome (>= 30 years) who received statin with omega-3 fatty acids and those receiving statin with fenofibrate were matched by propensity score (n = 39 165 in both groups). The primary outcome was MACE, including ischaemic heart disease (IHD), ischaemic stroke (IS), and death from cardiovascular causes. The risk of MACE was lower [hazard ratio (HR), 0.79; 95% confidence interval (CI), 0.74-0.83] in the fenofibrate group than in the omega-3 fatty acid group. Fenofibrate was associated with a lower incidence of IHD (HR, 0.72; 95% CI, 0.67-0.77) and hospitalization for heart failure (HR, 0.90; 95% CI, 0.82-0.97), but not IS (HR, 0.90; 95% CI, 0.81-1.00) nor death from cardiovascular causes (HR, 1.07; 95% CI, 0.97-1.17). The beneficial effect of fenofibrate compared to omega-3 fatty acids was prominent in patients with preexisting atherosclerotic cardiovascular disease and those receiving lower doses of omega-3 fatty acids (<= 2 g per day).Conclusion In a real-world setting, fenofibrate use was associated with a lower risk of MACE compared with low-dose omega-3 fatty acids when added to statins in people with metabolic syndrome. Graphical Abstract
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