Evidence map›Paper›PMID 28830976›Full record

ArticleStroke2017

Omega-3 Fatty Acids and Incident Ischemic Stroke and Its Atherothrombotic and Cardioembolic Subtypes in 3 US Cohorts.

Hamidreza Saber, Mohammad Yawar Yakoob, Peilin Shi, W T Longstreth, Rozenn N Lemaitre, David Siscovick, Kathryn M Rexrode, Walter C Willett, Dariush Mozaffarian

Open access · bronzeAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 3 pooled it
4.5field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 78 citations in OpenAlex.

  1. Pooled it
  2. Omega-3 Polyunsaturated Fatty Acids and Stroke Burden.International journal of molecular sciences · 2019
    Pooled it
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  4. Trial
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  9. Lipidomic insights on abdominal aortic aneurysm and peripheral arterial disease.Journal of molecular medicine (Berlin, Germany) · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

Hamidreza SaberFrom the Department of Neurology, Wayne State University School of Medicine, Detroit, MI (H.S.); Department of Epidemiology (H.S., M.Y.Y., W.C.W.) and Department of Nutrition (W.C.W.), Harvard T.H. Chan School of Public Health, Boston, MA; Tufts Friedman School of Nutrition Science and Policy, Boston, MA (P.S., D.M.); Departments of Neurology and Epidemiology (W.T.L.) and Departments of Medicine and Epidemiology (R.N.L.), University of Washington, Seattle; New York Academy of Medicine (D.S.); and Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.).
Mohammad Yawar YakoobFrom the Department of Neurology, Wayne State University School of Medicine, Detroit, MI (H.S.); Department of Epidemiology (H.S., M.Y.Y., W.C.W.) and Department of Nutrition (W.C.W.), Harvard T.H. Chan School of Public Health, Boston, MA; Tufts Friedman School of Nutrition Science and Policy, Boston, MA (P.S., D.M.); Departments of Neurology and Epidemiology (W.T.L.) and Departments of Medicine and Epidemiology (R.N.L.), University of Washington, Seattle; New York Academy of Medicine (D.S.); and Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.).
Peilin ShiFrom the Department of Neurology, Wayne State University School of Medicine, Detroit, MI (H.S.); Department of Epidemiology (H.S., M.Y.Y., W.C.W.) and Department of Nutrition (W.C.W.), Harvard T.H. Chan School of Public Health, Boston, MA; Tufts Friedman School of Nutrition Science and Policy, Boston, MA (P.S., D.M.); Departments of Neurology and Epidemiology (W.T.L.) and Departments of Medicine and Epidemiology (R.N.L.), University of Washington, Seattle; New York Academy of Medicine (D.S.); and Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.).
W T LongstrethFrom the Department of Neurology, Wayne State University School of Medicine, Detroit, MI (H.S.); Department of Epidemiology (H.S., M.Y.Y., W.C.W.) and Department of Nutrition (W.C.W.), Harvard T.H. Chan School of Public Health, Boston, MA; Tufts Friedman School of Nutrition Science and Policy, Boston, MA (P.S., D.M.); Departments of Neurology and Epidemiology (W.T.L.) and Departments of Medicine and Epidemiology (R.N.L.), University of Washington, Seattle; New York Academy of Medicine (D.S.); and Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.).
Rozenn N LemaitreFrom the Department of Neurology, Wayne State University School of Medicine, Detroit, MI (H.S.); Department of Epidemiology (H.S., M.Y.Y., W.C.W.) and Department of Nutrition (W.C.W.), Harvard T.H. Chan School of Public Health, Boston, MA; Tufts Friedman School of Nutrition Science and Policy, Boston, MA (P.S., D.M.); Departments of Neurology and Epidemiology (W.T.L.) and Departments of Medicine and Epidemiology (R.N.L.), University of Washington, Seattle; New York Academy of Medicine (D.S.); and Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.).
David SiscovickFrom the Department of Neurology, Wayne State University School of Medicine, Detroit, MI (H.S.); Department of Epidemiology (H.S., M.Y.Y., W.C.W.) and Department of Nutrition (W.C.W.), Harvard T.H. Chan School of Public Health, Boston, MA; Tufts Friedman School of Nutrition Science and Policy, Boston, MA (P.S., D.M.); Departments of Neurology and Epidemiology (W.T.L.) and Departments of Medicine and Epidemiology (R.N.L.), University of Washington, Seattle; New York Academy of Medicine (D.S.); and Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.).
Kathryn M RexrodeFrom the Department of Neurology, Wayne State University School of Medicine, Detroit, MI (H.S.); Department of Epidemiology (H.S., M.Y.Y., W.C.W.) and Department of Nutrition (W.C.W.), Harvard T.H. Chan School of Public Health, Boston, MA; Tufts Friedman School of Nutrition Science and Policy, Boston, MA (P.S., D.M.); Departments of Neurology and Epidemiology (W.T.L.) and Departments of Medicine and Epidemiology (R.N.L.), University of Washington, Seattle; New York Academy of Medicine (D.S.); and Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.).
Walter C WillettFrom the Department of Neurology, Wayne State University School of Medicine, Detroit, MI (H.S.); Department of Epidemiology (H.S., M.Y.Y., W.C.W.) and Department of Nutrition (W.C.W.), Harvard T.H. Chan School of Public Health, Boston, MA; Tufts Friedman School of Nutrition Science and Policy, Boston, MA (P.S., D.M.); Departments of Neurology and Epidemiology (W.T.L.) and Departments of Medicine and Epidemiology (R.N.L.), University of Washington, Seattle; New York Academy of Medicine (D.S.); and Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.).
Dariush MozaffarianFrom the Department of Neurology, Wayne State University School of Medicine, Detroit, MI (H.S.); Department of Epidemiology (H.S., M.Y.Y., W.C.W.) and Department of Nutrition (W.C.W.), Harvard T.H. Chan School of Public Health, Boston, MA; Tufts Friedman School of Nutrition Science and Policy, Boston, MA (P.S., D.M.); Departments of Neurology and Epidemiology (W.T.L.) and Departments of Medicine and Epidemiology (R.N.L.), University of Washington, Seattle; New York Academy of Medicine (D.S.); and Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.). dariush.mozaffarian@tufts.edu.
New York Academy of Medicine · USBrigham and Women's Hospital · USTufts University · USUniversity of Washington · USWayne State University · US

Funding

Statistical MethodsP01CA087969 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI TWOROGER, SHELLEY S · 2000 to 2019
$77.8M
Validity of Diet and Activity Measures in WomenP01CA055075 · NCI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI WILLETT, WALTER C. · 1991 to 2009
$41.8M
Long Term Multidisciplinary Study of Cancer in Women: The Nurses Health StudyUM1CA186107 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ELIASSEN, A. HEATHER, STAMPFER, MEIR · 2014 to 2023
$22.3M
Cancer Epidemiology Cohort in Male Health ProfessionalsU01CA167552 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Lorelei Mucci, Walter C. Willett · 2017 to 2026
$17.0M
RISK FACTORS FOR CVD IN WOMENR01HL034594 · NHLBI · TULANE UNIVERSITY OF LOUISIANA · PI JoAnn Elisabeth Manson, Lu Qi · 1985 to 2026
$13.8M
Dietary Etiology of Heart DiseaseR01HL035464 · NHLBI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI ERIC B RIMM, Qi Sun · 1986 to 2026
$13.6M
Cancer Epidemiology Cohort in Male Health ProfessionalsUM1CA167552 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI WILLETT, WALTER C. · 2012 to 2016
$11.5M
BIOCHEMICAL MARKERS IN THE NURSES'HEALTH STUDY COHORTR01CA049449 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI HANKINSON, SUSAN E · 1989 to 2008
$11.3M
Risk Factors for Ischemic Stroke in WomenR01HL088521 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI REXRODE, KATHRYN M · 2008 to 2025
$9.9M
Exceptional Survival: Trajectories to Functional Aging (CHS All Stars)R01AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2004 to 2016
$9.5M
DIETARY PATTERNS AND RISK OF CARDIOVASCULAR DISEASER01HL060712 · NHLBI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI HU, FRANK B, QI, QIBIN · 1998 to 2021
$8.0M
BIOCHEMICAL AND GENETIC MARKERS OF TYPE 2 DIABETES RISKR01DK058845 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI HU, FRANK B · 2001 to 2013
$7.8M
NCI NIH HHS P01 CA055075NCI NIH HHS P01 CA087969NCI NIH HHS R01 CA049449NCI NIH HHS U01 CA049449NCI NIH HHS U01 CA167552NCI NIH HHS UM1 CA167552NCI NIH HHS UM1 CA186107NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS R01 HL034594NHLBI NIH HHS R01 HL035464NHLBI NIH HHS R01 HL060712NHLBI NIH HHS R01 HL085710NHLBI NIH HHS R01 HL088521NHLBI NIH HHS R01 HL102214NHLBI NIH HHS U01 HL080295NIA NIH HHS R01 AG015928NIA NIH HHS R01 AG020098NIA NIH HHS R01 AG023629NIA NIH HHS R01 AG027058NIA NIH HHS R56 AG020098NIA NIH HHS R56 AG023629NIDDK NIH HHS R01 DK058845NIEHS NIH HHS R01 ES013692NIEHS NIH HHS R01 ES014433
6 · The paper itself

Abstract

background and purposeThe associations of individual long-chain n-3 polyunsaturated fatty acids with incident ischemic stroke and its main subtypes are not well established. We aimed to investigate prospectively the relationship of circulating eicosapentaenoic acid, docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) with risk of total ischemic, atherothrombotic, and cardioembolic stroke.

methodsWe measured circulating phospholipid fatty acids at baseline in 3 separate US cohorts: CHS (Cardiovascular Health Study), NHS (Nurses' Health Study), and HPFS (Health Professionals Follow-Up Study). Ischemic strokes were prospectively adjudicated and classified into atherothrombotic (large- and small-vessel infarctions) or cardioembolic by imaging studies and medical records. Risk according to fatty acid levels was assessed using Cox proportional hazards (CHS) or conditional logistic regression (NHS, HPFS) according to study design. Cohort findings were pooled using fixed-effects meta-analysis.

resultsA total of 953 incident ischemic strokes were identified (408 atherothrombotic, 256 cardioembolic, and 289 undetermined subtypes) during median follow-up of 11.2 years (CHS) and 8.3 years (pooled, NHS and HPFS). After multivariable adjustment, lower risk of total ischemic stroke was seen with higher DPA (highest versus lowest quartiles; pooled hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.58-0.92) and DHA (HR, 0.80; 95% CI, 0.64-1.00) but not eicosapentaenoic acid (HR, 0.94; 95% CI, 0.77-1.19). DHA was associated with lower risk of atherothrombotic stroke (HR, 0.53; 95% CI, 0.34-0.83) and DPA with lower risk of cardioembolic stroke (HR, 0.58; 95% CI, 0.37-0.92). Findings in each individual cohort were consistent with pooled results.

conclusionsIn 3 large US cohorts, higher circulating levels of DHA were inversely associated with incident atherothrombotic stroke and DPA with cardioembolic stroke. These novel findings suggest differential pathways of benefit for DHA, DPA, and eicosapentaenoic acid.

Indexed as

AdultAgedAged, 80 and overBiomarkersBrain IschemiaCardiovascular DiseasesCase-Control StudiesCohort StudiesFatty Acids, Omega-3FemaleFollow-Up StudiesHumansIncidenceIntracranial ArteriosclerosisIntracranial EmbolismIntracranial ThrombosisBiomarkersFatty Acids, Omega-3atherosclerosisepidemiologyhypertensionincidencestroke

Identifiers

PMID28830976
PMCPMC5769157
OpenAlexW2746828737

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.