Evidence map›Paper›PMID 40974959›Full record

ArticleJACC. Advances2025

Effects of Eicosapentaenoic Acid vs Eicosapentaenoic/Docosahexaenoic Acids on Cardiovascular Mortality: Meta-Analysis of Clinical Trials.

John P Sheppard, Leonard Palatnic, Suvasini Lakshmanan, Thomas Drago, Jaspreet Bhogal, Sion K Roy, Deepak L Bhatt, Matthew J Budoff, John R Nelson

Abstract read
In one paragraph

Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Review
  2. DHA ModulatesInternational journal of molecular sciences · 2025
    Article
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.

John P SheppardSmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Leonard PalatnicUniversity at Buffalo, Buffalo, New York, USA.
Suvasini LakshmananLundquist Institute/Harbor-UCLA Medical Center, Torrance, California, USA.
Thomas DragoSmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Jaspreet BhogalSmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Sion K RoyLundquist Institute/Harbor-UCLA Medical Center, Torrance, California, USA.
Deepak L BhattMount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Matthew J BudoffLundquist Institute/Harbor-UCLA Medical Center, Torrance, California, USA. Electronic address: mbudoff@lundquist.org.
John R NelsonCalifornia Cardiovascular Institute, Fresno, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPurified eicosapentaenoic acid (EPA) and mixed eicosapentaenoic/docosahexaenoic acids (EPA/DHA) are omega-3 polyunsaturated fatty acids (n-3 PUFAs) of interest for preventing cardiovascular disease (CVD) as adjunct to statins. Randomized clinical trial (RCT) evidence continues to emerge, including data from the RESPECT-EPA (Randomized Trial for Evaluation in Secondary Prevention Efficacy of Combination Therapy-Statin and Eicosapentaenoic Acid) trial, but n-3 PUFAs' roles in prevention remains controversial.

objectivesThe objective of the study was to assess the efficacy of EPA vs EPA/DHA compared to the standard preventive therapy across published RCTs investigating the use of n-3 PUFAs for primary or secondary prevention of CVD.

methodsFollowing a prespecified protocol registered in the PROSPERO database (CRD42023390587), we identified RCTs reporting CVD-attributable mortality in patients randomized to EPA, EPA/DHA, or a standard preventive therapy for primary or secondary CVD prevention. We used random effects meta-analysis to estimate pooled HRs of CVD-attributable mortality achieved with EPA or EPA/DHA relative to the standard preventive therapy.

resultsSixteen RCTs met the inclusion criteria, representing 127,771 patients in total (41% women, mean age 64 ± 5 years). Median follow-up was 3.7 years (IQR: 2.7-5.0 years). Compared to the standard preventive therapy, CVD-attributable mortality was significantly reduced with purified EPA (HR: 0.79 [95% CI: 0.67-0.94]; P = 0.006); this effect was less for EPA/DHA (HR: 0.92 [95% CI: 0.84-1.00]; P = 0.044).

conclusionsEPA lowered incident CVD-attributable mortality in RCTs investigating its use for primary or secondary CVD prevention. Relative to EPA, benefits reported with EPA/DHA were attenuated. Although more work is needed to understand these differences, EPA should preferentially be used in cardiovascular conditions for which it is indicated.

Indexed as

cardiovascular mortalitydocosahexaenoic acideicosapentaenoic acidmeta-analysisomega-3 fatty acids

Identifiers

PMID40974959
PMCPMC12791848

What OpenQuestion holds

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Registered trials

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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.