(P06-01-26) Omega-3 Fatty Acid Dietary Supplementation and Risk for Atrial Fibrillation: A Meta-Analysis of 18 Randomized Trials Including 25,692 Participants

Saturday, July 25, 2026

11:30 AM - 12:30 PM ET

Location: Poster Board E-61

Presenting Author(s)

Nada R. Abuknesha, PhD (she/her/hers)

Associate Scientist
Fatty Acid Research Institute
Sioux Falls, South Dakota, United States

Co-Author(s)

JO

James H. O’Keefe, MD

Fatty Acid Research Institute; Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, United States
FQ

Frank Qian, MD, MPH

Section of Cardiovascular Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, United States
NT

Nathan L. Tintle, PhD

Senior Scientist
Fatty Acid Research Institute
SIOUX FALLS, South Dakota, United States
Willam S. Harris, PhD

Founder and President
Fatty Acid Research Institute
Sioux Falls, South Dakota, United States

Disclosure(s):

Nada R. Abuknesha, PhD: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: Our recent meta-analysis suggested that atrial fibrillation (AF) risk increased with omega-3 (EPA+DHA) treatment only in high cardiovascular (CV) disease–risk populations receiving high doses ( >1500 mg/day), typically from prescription formulations. As uncertainty remains regarding the safety of omega-3 dietary supplements, we conducted a secondary meta-analysis restricted to trials using dietary supplements to examine their association with incident AF risk.

Methods: We used the dataset from our previous meta-analysis (PROSPERO CRD420251233813) and restricted analyses to randomized trials using dietary omega-3 supplements. Dose- and CV risk–stratified analyses used in the original study were not applied. Odds ratios (ORs) were estimated using logistic regression with Firth’s correction and pooled using inverse-variance weighted random-effects meta-analysis (metafor, R).

Results: A total of 18 RCTs (n=25,692) were included. Across participants, the sample size–weighted mean baseline age was 67 years (range 53–78), and 57% were male. Across trials, the mean EPA+DHA dose was 1758 mg/day (range 600–3000 mg/day), and the mean intervention duration was 24.4 months. EPA+DHA was most commonly administered in triglyceride-based formulations (55%). Across studies, 877 incident AF events occurred (omega-3: 462 [3.5%]; control: 415 [3.3%]). There was no statistically significant increase in AF risk (pooled OR 1.11, 95% CI 0.94–1.32; p=0.22; I²=6.2%).

Conclusions: Use of EPA+DHA dietary supplements was not associated with increased AF risk. These findings are consistent with the U.S. Food and Drug Administration determination that EPA+DHA intakes of up to 3000 mg/day are generally recognized as safe, providing reassurance regarding the CV safety of omega-3 supplements, even at doses overlapping with those used in prescription omega-3 trials where AF signal was observed.

Funding Sources: Supported by the Global Organization for EPA and DHA Omega-3s (GOED)