--- title: "Effect of omega-3 fatty acids on cardiovascular outcomes: a…" description: "Omega-3 fatty acids reduce cardiovascular risks, with EPA monotherapy showing greater benefits but also increased risks of bleeding and atrial…" url: "https://magellanlongevity.com/study/d34505026.md" canonical: "https://magellanlongevity.com/study/d34505026.html" html: "https://magellanlongevity.com/study/d34505026.html" type: "study" study_key: "d34505026" journal: "EClinicalMedicine" year: 2021 pmid: "34505026" doi: "10.1016/j.eclinm.2021.100997" citations: 1 updated: 2026-09-02 author: "Gabriel Radu, DO" author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765." publisher: "Magellan Longevity" content_format: "markdown" --- # Effect of omega-3 fatty acids on cardiovascular outcomes: a systematic review and meta-analysis [Home](https://magellanlongevity.com/) › [Research map](https://magellanlongevity.com/longevity-research-map.html) › Effect of omega-3 fatty acids on cardiovascular outcomes:… **HTML version:** https://magellanlongevity.com/study/d34505026.html · **In the Magellan app:** https://magellanlongevity.com/#/study/d34505026 ## Citation | Field | Value | | --- | --- | | Journal | EClinicalMedicine | | Year | 2021 | | PMID | [34505026](https://pubmed.ncbi.nlm.nih.gov/34505026/) | | DOI | [10.1016/j.eclinm.2021.100997](https://doi.org/10.1016/j.eclinm.2021.100997) | | Study key | d34505026 | ## Takeaway Omega-3 fatty acids reduce cardiovascular risks, with EPA monotherapy showing greater benefits but also increased risks of bleeding and atrial fibrillation. ## The question What are the effects of omega-3 fatty acids, specifically EPA and EPA+DHA, on fatal and non-fatal cardiovascular outcomes? ## Hypothesis The study aimed to determine the effectiveness of omega-3 FAs on cardiovascular outcomes and examine potential variability between EPA monotherapy and EPA+DHA therapy. ## Methods A meta-analysis of 38 randomized controlled trials was conducted, including 149,051 participants. The trials were stratified by EPA monotherapy and EPA+DHA therapy. Random-effects rate ratios (RRs) with 95% confidence intervals were estimated, and the certainty of evidence was rated using GRADE. Key outcomes included cardiovascular mortality, non-fatal cardiovascular outcomes, bleeding, and atrial fibrillation (AF). ## Results Omega-3 FAs were associated with reductions in cardiovascular mortality (RR, 0.93), non-fatal myocardial infarction (MI) (RR, 0.87), coronary heart disease events (CHD) (RR, 0.91), major adverse cardiovascular events (MACE) (RR, 0.95), and revascularization (RR, 0.91). EPA monotherapy showed greater reductions for cardiovascular mortality (RR, 0.82), non-fatal MI (RR, 0.72), and CHD events (RR, 0.73) compared to EPA+DHA (cardiovascular mortality RR, 0.94; non-fatal MI RR, 0.92; CHD events RR, 0.94). Omega-3 FAs increased incident AF (RR, 1.26), and EPA monotherapy was associated with a higher risk of total bleeding (RR, 1.49) and AF (RR, 1.35). ## Conclusion Omega-3 fatty acids reduced cardiovascular mortality and improved cardiovascular outcomes. The cardiovascular risk reduction was more prominent with EPA monotherapy than with EPA+DHA. ## Limitations The abstract states 'None' for limitations. ## Verbatim from the abstract > Omega-3 fatty acids reduced cardiovascular mortality and improved cardiovascular outcomes ## Rate Ratios for Cardiovascular Outcomes with Omega-3 Fatty Acids | Measure | Rate Ratio | | --- | --- | | Cardiovascular Mortality (Overall) | 0.93 | | Non-fatal MI (Overall) | 0.87 | | CHD Events (Overall) | 0.91 | | MACE (Overall) | 0.95 | | Revascularization (Overall) | 0.91 | | Incident AF (Overall) | 1.26 | | Cardiovascular Mortality (EPA) | 0.82 | | Cardiovascular Mortality (EPA+DHA) | 0.94 | | Non-fatal MI (EPA) | 0.72 | | Non-fatal MI (EPA+DHA) | 0.92 | | CHD Events (EPA) | 0.73 | | CHD Events (EPA+DHA) | 0.94 | | Total Bleeding (EPA) | 1.49 | | AF (EPA) | 1.35 | *Rate ratios for various cardiovascular outcomes, showing overall effects of omega-3 FAs and stratified effects for EPA monotherapy versus EPA+DHA therapy.* ## Where this study is used on Magellan This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions. | Compound or device | Evidence grade | Graded pages | | --- | --- | --- | | Omega-3 EPA/DHA Fish Oil | Moderate evidence | [Omega-3 EPA/DHA Fish Oil](https://magellanlongevity.com/p/128.md) | ## Reference 1. **Effect of omega-3 fatty acids on cardiovascular outcomes: a systematic review and meta-analysis** EClinicalMedicine 2021 · [PMID 34505026](https://pubmed.ncbi.nlm.nih.gov/34505026/) · [DOI 10.1016/j.eclinm.2021.100997](https://doi.org/10.1016/j.eclinm.2021.100997) > Omega-3 fatty acids reduced cardiovascular mortality and improved cardiovascular outcomes ## Structured data ```json {"@context":"https://schema.org","@graph":[{"@type":"MedicalWebPage","@id":"https://magellanlongevity.com/study/d34505026.html#page","url":"https://magellanlongevity.com/study/d34505026.html","name":"Effect of omega-3 fatty acids on cardiovascular outcomes: a systematic review and meta-analysis","description":"Omega-3 fatty acids reduce cardiovascular risks, with EPA monotherapy showing greater benefits but also increased risks of bleeding and atrial…","inLanguage":"en","isPartOf":{"@type":"WebSite","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"author":{"@type":"Person","name":"Gabriel Radu, DO","jobTitle":"Physiatrist (PM&R)","identifier":[{"@type":"PropertyValue","name":"NPI","value":"1376861765"},{"@type":"PropertyValue","name":"NY medical license","value":"275110"}]},"publisher":{"@type":"Organization","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"encoding":{"@type":"MediaObject","encodingFormat":"text/markdown","contentUrl":"https://magellanlongevity.com/study/d34505026.md"},"dateModified":"2026-09-02"},{"@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://magellanlongevity.com/"},{"@type":"ListItem","position":2,"name":"Research map","item":"https://magellanlongevity.com/longevity-research-map.html"},{"@type":"ListItem","position":3,"name":"Effect of omega-3 fatty acids on cardiovascular outcomes:…","item":"https://magellanlongevity.com/study/d34505026.html"}]},{"@type":"ScholarlyArticle","@id":"https://magellanlongevity.com/study/d34505026.html#study","name":"Effect of omega-3 fatty acids on cardiovascular outcomes: a systematic review and meta-analysis","headline":"Effect of omega-3 fatty acids on cardiovascular outcomes: a systematic review and meta-analysis","datePublished":"2021","isPartOf":{"@type":"Periodical","name":"EClinicalMedicine"},"identifier":"PMID:34505026","url":"https://pubmed.ncbi.nlm.nih.gov/34505026/","sameAs":"https://doi.org/10.1016/j.eclinm.2021.100997","abstract":"Omega-3 fatty acids reduce cardiovascular risks, with EPA monotherapy showing greater benefits but also increased risks of bleeding and atrial fibrillation."}]} ``` ## Related on Magellan Longevity - [Omega-3 EPA/DHA Fish Oil](https://magellanlongevity.com/p/128.md) — product graded on this and related evidence - [Evidence: anti-inflammatory long-chain PUFAs](https://magellanlongevity.com/study/s128.md) - [Effect of Omega-3 Dosage on Cardiovascular Outcomes: An Updated Meta-Analysis of…](https://magellanlongevity.com/study/d32951855.md) - [Longevity research map](https://magellanlongevity.com/longevity-research-map.html) - [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md) ## Scope and disclosures Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication. Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases. Reviewed for accuracy by a board-certified physician (DO).