ArticleStroke2024
Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies.
Erratum issuedOpen access · greenAbstract read
In one paragraph
Article in Stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 27 papers, 2 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
6.1field-weighted citation impact, top 2% of its field
What it found
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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.
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.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Effects of Omega-3 Fatty Acid Treatment on Risk for Atrial Fibrillation: An Updated Meta-Analysis of 35 Trials including 114 592 Individuals.Circulation. Arrhythmia and electrophysiology · 2026Pooled it
- Omega-3 and Risk of atrial fibrillation: Vagally-mediated double-edged sword.Progress in cardiovascular diseasesPooled it
- A Bayesian analysis of the VITAL trial: effects of ω-3 fatty acid supplementation on cardiovascular events.The American journal of clinical nutrition · 2025Trial
- Effects of Add-On Icosapent Ethyl With Standard Treatment on Functional Outcomes and Inflammatory Biomarkers in Acute Ischemic Stroke: A Blinded Randomized Controlled Trial.Annals of clinical and translational neurology · 2026Article
- Modifiable Correlates With Systemic Thromboxane Generation and Association With Cardiovascular Outcomes: Results From the Framingham Heart Study.Arteriosclerosis, thrombosis, and vascular biology · 2026Article
- A Clinician's Guide for Trending Cardiovascular Nutritional Controversies in 2026.JACC. Advances · 2026Review
- Association of Higher Dietary Omega-3 Fatty Acid Intake With Cardiovascular-Kidney-Metabolic Syndrome Stage Severity and Mortality in US Adults: A Cross-Sectional and Prospective Cohort Analysis of NHANES 1999 to 2018.Journal of the American Heart Association · 2026Observational
- Reducing Glucocorticoid Burden in Lupus with Omega-3 Fatty Acids: Docosahexaenoic Acid Augments Prednisone Efficacy in Maintaining Cyclophosphamide-Induced Remission of Preclinical Lupus Nephritis.bioRxiv : the preprint server for biology · 2026Article
- From anti-inflammation to pro-resolution: a new paradigm for specialized pro-resolving mediators in regulating neuroinflammation and repair after cerebral ischemia-reperfusion.Frontiers in immunology · 2026Review
- Molecular Insights into the Functional Roles of Variants in the <italic>FADS</italic> Gene Cluster on Omega-3 Long-Chain Polyunsaturated Fatty Acid Synthesis.Lifestyle genomics · 2026Review
- Development of a blood-based lipidomic fat quality score for the risk of ischemic stroke.European stroke journal · 2026Article
- Associations Between Plasma Omega-3 and Fish Oil Use With Risk of Atrial Fibrillation in the UK Biobank.Journal of the American Heart Association · 2025Article
- Effects of Omega-3 Fatty Acid Treatment on Risk for Atrial Fibrillation: An Updated Meta-Analysis of 34 Trials including 114,326 Individuals.medRxiv : the preprint server for health sciences · 2025Article
- Causal Relationship Between Circulating Omega-3 Fatty Acid and Cerebral Small Vessel Disease: A Mendelian Randomization Study.Food science & nutrition · 2025Article
- N-3 Fatty Acids (EPA and DHA) and Cardiovascular Health - Updated Review of Mechanisms and Clinical Outcomes.Current atherosclerosis reports · 2025Review
- The GPR120 agonist TUG-891 mitigates ischemic brain injury by attenuating endoplasmic reticulum stress and apoptosis via the PI3K/AKT signaling pathway.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Article
- Impaired membrane lipids in ischemic stroke: a key player in inflammation and thrombosis.Journal of neuroinflammation · 2025Article
- Fatty Acid Ratios Versus Conventional Risk Factors in Stroke: Insights into Severe Disability and Mortality Outcomes.Nutrients · 2025Article
- Non-Anticoagulation Strategies Aimed at Primary Stroke Prevention in Nascent Atrial Fibrillation.Biomedicines · 2025Review
- Untargeted metabolomics unveils critical metabolic signatures in novel phenotypes of acute ischemic stroke.Metabolic brain disease · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
72 authors at 20 institutions in 17 countries.
James H O'KeefeSaint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O., E.L.O.).ORCID 0000-0002-3376-5822
Nathan L TintleFatty Acid Research Institute (N.L.T., W.S.H., A.S.-V., J.W.), Sioux Falls, SD.
William S HarrisFatty Acid Research Institute (N.L.T., W.S.H., A.S.-V., J.W.), Sioux Falls, SD.
Evan L O'KeefeSaint Luke's Mid America Heart Institute, University of Missouri-Kansas City (J.H.O., E.L.O.).ORCID 0000-0002-2746-2323
Aleix Sala-VilaFatty Acid Research Institute (N.L.T., W.S.H., A.S.-V., J.W.), Sioux Falls, SD.
John AttiaThe University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia (J. Attia, G.M.G., A.H.).ORCID 0000-0001-9800-1308
G Manohar GargThe University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia (J. Attia, G.M.G., A.H.).ORCID 0000-0003-0514-0865
Alexis HureThe University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia (J. Attia, G.M.G., A.H.).ORCID 0000-0003-2225-0986
Christian Sørensen BorkDepartment of Cardiology, Aalborg University Hospital, Denmark (C.S.B.).ORCID 0000-0001-5233-2902
Erik Berg SchmidtDepartment of Clinical Medicine (E.B.S.), Aalborg University Hospital, Denmark.ORCID 0000-0002-0623-5666
Stine Krogh VenøDepartment of Clinical Biochemistry (S.K.V.), Aalborg University Hospital, Denmark.
Kuo-Liong ChienNational Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (K.-L.C.).ORCID 0000-0003-4979-8351
Yun-Yu Amelia ChenDepartment of Medical Research, Taichung Veterans General Hospital, Taiwan (Y.-Y.C.).ORCID 0000-0001-7009-7838
Sarah EgertInstitute of Nutrition and Food Sciences and Nutritional Physiology, University of Bonn, Germany (S.E.).
Tobias Rudholm FeldreichDalarna University, School of Health and Welfare, Falun, Sweden (T.R.F.).
Johan ÄrnlövDivision of Family Medicine and Primary Care, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Solna, Sweden (J. Ärnlöv).ORCID 0000-0002-6933-4637
Lars LindDepartment of Medical Sciences Cardiovascular Epidemiology, Uppsala University, Sweden (L.L.).ORCID 0000-0003-2335-8542
Nita G ForouhiMRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, United Kingdom (N.G.F., F.I.).ORCID 0000-0002-5041-248X
Johanna M GeleijnseDivision of Human Nutrition and Health, Wageningen University and Research, the Netherlands (J.M.G., K.P.).ORCID 0000-0001-7638-0589
Kamalita PertiwiDivision of Human Nutrition and Health, Wageningen University and Research, the Netherlands (J.M.G., K.P.).ORCID 0000-0003-2861-9051
Fumiaki ImamuraMRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, United Kingdom (N.G.F., F.I.).ORCID 0000-0002-6841-8396
Vanessa de Mello LaaksonenInstitute of Public Health and Clinical Nutrition (V.d.M.L., W.M.U., J.T., M.A.L., J.V.), School of Medicine, University of Eastern Finland, Kuopio, Finland.ORCID 0000-0003-3414-6983
W Matti UusitupaInstitute of Public Health and Clinical Nutrition (V.d.M.L., W.M.U., J.T., M.A.L., J.V.), School of Medicine, University of Eastern Finland, Kuopio, Finland.ORCID 0000-0001-6052-2001
Jaakko TuomilehtoInstitute of Public Health and Clinical Nutrition (V.d.M.L., W.M.U., J.T., M.A.L., J.V.), School of Medicine, University of Eastern Finland, Kuopio, Finland.ORCID 0000-0002-3424-0745
Markku LaaksoDepartment of Internal Medicine (M.L.), School of Medicine, University of Eastern Finland, Kuopio, Finland.ORCID 0000-0002-3394-7749
Maria Anneli LankinenInstitute of Public Health and Clinical Nutrition (V.d.M.L., W.M.U., J.T., M.A.L., J.V.), School of Medicine, University of Eastern Finland, Kuopio, Finland.ORCID 0000-0002-9158-283X
Danielle LaurinCHU de Québec-Université Laval and VITAM Research Centers, Centre d'Excellence sur le Vieillissement de Québec, Canada (D.L., P.-H.C.).ORCID 0000-0001-5032-2452
Pierre-Hugues CarmichaelCHU de Québec-Université Laval and VITAM Research Centers, Centre d'Excellence sur le Vieillissement de Québec, Canada (D.L., P.-H.C.).ORCID 0000-0002-5324-862X
Joan LindsaySchool of Epidemiology and Public Health, University of Ottawa, Canada (J.L.).
Karin LeanderKarolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden (K.L., F.L.).ORCID 0000-0002-1404-9222
Federica LaguzziKarolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden (K.L., F.L.).ORCID 0000-0003-3551-1348
Brenton R SwensonCardiovascular Health Research Unit (B.R.S.), University of Washington, Seattle.ORCID 0000-0002-4176-8273
William T LongstrethDepartments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle.
JoAnn E MansonDepartment of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA (J.E.M., S.M., N.R.C.).ORCID 0000-0002-9426-7595
Samia MoraDepartment of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA (J.E.M., S.M., N.R.C.).ORCID 0000-0001-6283-0980
Nancy R CookDepartment of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA (J.E.M., S.M., N.R.C.).ORCID 0000-0002-9705-0842
Matti MarklundThe George Institute for Global Health, University of New South Wales, Newtown, Australia (M.M.).ORCID 0000-0002-3320-796X
Debora Melo van LentGlenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas, San Antonio (D.M.v.L.).ORCID 0000-0002-7392-9289
Rachel MurphyCancer Control Research, British Columbia Cancer, School of Population and Public Health, University of British Columbia, Vancouver, Canada (R.M.).ORCID 0000-0003-4383-5641
Vilmundur GudnasonIcelandic Heart Institute, Kopavogur, Iceland (V.G.).ORCID 0000-0001-5696-0084
Toshihara NinomiyaDepartment of Epidemiology and Public Health and Center for Cohort Studies, Kyushu University, Fukouka, Japan (T.N., Y.H.).
Yoichiro HirakawaDepartment of Epidemiology and Public Health and Center for Cohort Studies, Kyushu University, Fukouka, Japan (T.N., Y.H.).
Frank QianHarvard Medical School, T.H. Chan School of Public Health and Beth Deaconess Medical Center, Boston, MA (F.Q.).ORCID 0000-0002-5579-3410
Qi SunHarvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women's Hospital, Boston, MA (Q.S., F.H.).ORCID 0000-0002-8480-1563
Frank HuHarvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women's Hospital, Boston, MA (Q.S., F.H.).ORCID 0000-0002-8233-6274
Andres V Ardisson KoratUSDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA (A.V.A.K.).ORCID 0000-0003-4599-2245
Ulf RisérusDepartment of Public Health and Caring Sciences Clinical Nutrition and Metabolism Unit, Uppsala University, Sweden (U.R.).ORCID 0000-0002-8620-4586
Iolanda LázaroHospital del Mar Medical Research Institute, Barcelona, Spain (A.S.-V., I.L.).ORCID 0000-0002-6172-9845
Cecilia SamieriBordeaux Population Health Research Centre, University of Bordeaux, France (C.S., M.L.G., C.H.).
Mélanie Le GoffBordeaux Population Health Research Centre, University of Bordeaux, France (C.S., M.L.G., C.H.).ORCID 0000-0003-2848-6287
Catherine HelmerBordeaux Population Health Research Centre, University of Bordeaux, France (C.S., M.L.G., C.H.).
Marinka SteurDepartment of Epidemiology, University Medical Center Rotterdam, the Netherlands (M.S., T.V., M.K.I.).ORCID 0000-0002-9028-0290
Trudy VoortmanDepartment of Epidemiology, University Medical Center Rotterdam, the Netherlands (M.S., T.V., M.K.I.).ORCID 0000-0003-2830-6813
M Kamran IkramDepartment of Epidemiology, University Medical Center Rotterdam, the Netherlands (M.S., T.V., M.K.I.).ORCID 0000-0003-0173-9571
Toshiko TanakaNational Institutes of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD (T.T., L.F.).
Jayanta K DasTata Medical Center, Kolkata, India (J.K.D.).
Luigi FerrucciNational Institutes of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD (T.T., L.F.).ORCID 0000-0002-6273-1613
Stefania BandinelliAzienda Sanitaria Firenze, Geriatric Unit, Florence, Italy (S.B.).
Michael TsaiDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.T.).ORCID 0000-0001-7553-3408
Weihua GuanDivision of Biostatistics, University of Minnesota, Minneapolis (W.G.).ORCID 0000-0002-0956-9821
Parveen GargDepartment of Medicine, Cardiology, University of Southern California, Los Angeles (P.G.).ORCID 0000-0002-6482-2711
W M Monique VerschurenNational Institute for Public Health and the Environment Bilthoven, the Netherlands (W.M.M.V.).ORCID 0000-0003-2134-4227
Jolanda M A BoerNational Institute for Public Health and the Environment Bilthoven, the Netherlands (J.M.A.B., A.B.).ORCID 0000-0002-9714-4304
Anneke BiokstraNational Institute for Public Health and the Environment Bilthoven, the Netherlands (J.M.A.B., A.B.).ORCID 0009-0001-2062-8810
Jyrki VirtanenInstitute of Public Health and Clinical Nutrition (V.d.M.L., W.M.U., J.T., M.A.L., J.V.), School of Medicine, University of Eastern Finland, Kuopio, Finland.ORCID 0000-0002-0648-999X
Michael WagnerDepartments of Neurodegenerative Diseases and Geriatric Psychiatry and German Center for Neurodegenerative Diseases, University Hospital, Bonn, Germany (M.W.).ORCID 0000-0003-2589-6440
Jason WestraFatty Acid Research Institute (N.L.T., W.S.H., A.S.-V., J.W.), Sioux Falls, SD.
Luc AlbuissonUniversity of Denver, CO (L.A.).
Kazumasa YamagishiDepartment of Public Health Medicine, University of Tsukubu, Japan (K.Y.).ORCID 0000-0003-3301-5519
David S SiscovickDepartment of Epidemiology, New York Academy of Medicine (D.S.S.).ORCID 0000-0003-0461-175X
Rozenn N LemaitreDepartment of Medicine, University of Washington, Seattle (R.N.L.).ORCID 0000-0002-7038-1844
Dariush MozaffarianDivision of Cardiology, Tufts University, Boston, MA (D.M.).ORCID 0000-0001-7958-9492
University of Eastern Finland · FIBrigham and Women's Hospital · USAalborg University Hospital · DKErasmus MC · NLKarolinska Institutet · SENational Institute for Public Health and the Environment · NLNational Institute on Aging · USUniversité de Bordeaux · FRUniversity of Newcastle Australia · AUUniversity of Washington · USUppsala University · SEMRC Epidemiology Unit · GBNihon Fukushi University · JPSaint Luke's Hospital · USSanford Research · USTufts University · USUniversité Laval · CAAzienda Sanitaria di Firenze · ITBeth Israel Deaconess Medical Center · USCanadian Centre for Applied Research in Cancer Control · CA
Funding
The VITamin D and OmegA-3 TriaL (VITAL): Post-Intervention Follow-UpR01AT011729 · NCCIH · BRIGHAM AND WOMEN'S HOSPITAL · PI Jun Li, JoAnn Elisabeth Manson · 2021 to 2026
$5.2MCARDIOVASCULAR OUTCOMES RESEARCH TRAINING PROGRAMT32HL110837 · NHLBI · UNIVERSITY OF MISSOURI KANSAS CITY · PI JOHN A SPERTUS · 2012 to 2026
$5.0MCTSA Institutional Mentored Career Development Program (KL2)KL2TR002545 · NCATS · TUFTS UNIVERSITY BOSTON · PI FREUND, KAREN · 2018 to 2022
$5.0MTargeting the Active Resolution of Inflammation for Cardiovascular Disease PreventionR01HL160799 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI MORA, SAMIA · 2022 to 2025
$3.0MCirculating plasma metabolites, diet, and risk of type 2 diabetesR01DK112940 · NIDDK · BRIGHAM AND WOMEN'S HOSPITAL · PI HU, FRANK B, MORA, SAMIA · 2018 to 2021
$2.9MMedical Research Council MC_UU_00006/3NCATS NIH HHS KL2 TR002545NCCIH NIH HHS R01 AT011729NHLBI NIH HHS R01 HL160799NHLBI NIH HHS T32 HL110837NIDDK NIH HHS R01 DK112940
Abstract
backgroundThe effect of marine omega-3 PUFAs on risk of stroke remains unclear.
methodsWe investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual-level analysis using a prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome.
resultsAmong 183 291 study participants, there were 10 561 total strokes, 8220 ischemic strokes, and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76-0.91];
conclusionsHigher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.
Indexed as
Fatty Acids, Omega-3Hemorrhagic StrokeIschemic StrokeStrokeDocosahexaenoic AcidsEicosapentaenoic AcidHumansProspective StudiesRisk FactorsDocosahexaenoic AcidsEicosapentaenoic AcidFatty Acids, Omega-3atrial fibrillationcerebrovascular diseasefishfish oilstroke
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