Abstract 2367: Omega 3 Fatty Acid Supplementation Reduce One-Year Risk of Atrial Fibrillation in Patients Hospitalized with Myocardial Infarction

Background: Current medical strategies for avoidance of atrial fibrillation (AF) are of limited value. Anti-arrhythmic agents faced major challenges related to their limited efficacy and their serious and frequent side effects. Epidemiological studies, clinical trials and basic science support the role of Omega-3 fatty acids (n-3 PUFA) in reducing all cause mortality among patients with previous myocardial infarction (MI), mostly by reducing ventricular arrhythmias. However their effects regarding supraventricular arrhythmia are not well characterized. Aim: To assess the effect of supplementation with n-3 PUFA for the prevention of AF. Methods: Population study, linking administrative datasets from hospital discharge, prescription databases and vital statistics, including all consecutive patients with MI (code ICD-9: 410) in 6 Italian regions during a 3-year period. Follow up was extended up to one year or to time to event. A Cox regression model adjusted for propensity score (PS) quintiles was used. Further a PS-based 5 to 1 greedy matching algorithm and sensitivity analysis were used to assess robustness of our findings. Results: Three thousand two hundred and forty-two (3,242) patients were identified and included in the analysis. Of these, 208 (6.4%) were exposed to n-3 PUFA during follow up. Four out of 208 (1.9%) patients exposed to n-3 PUFA were hospitalized with AF during follow up as compared with 467 out of 3,034 (15.4%) of those not exposed to supplement n-3 PUFA. The PS-quintiles adjusted hazard ratio (HR) estimate was 0.19 (95%CI 0.07– 0.51; p=0.001). The PS based 5 to 1 greedy matching algorithm and sensitivity analysis confirm main results (HR=0.13; 95%CI 0.04 – 0.44; p=0.001). Conclusion: n-3 PUFA reduce the occurrence of one year AF in patients hospitalized with MI.