Evidence map›Paper›PMID 42395094›Full record

ArticleAmerican journal of preventive cardiology2026

Novel risk model for predicting incident atrial fibrillation in patients taking ω-3 fatty acid: sub-analysis of the STRENGTH randomized trial.

Tom Kai Ming Wang, Stephen J Nicholls, Clement Tan, Becky Yi-Wen Liao, Kathy Wolski, Julie St John, Steven E Nissen

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of preventive cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

7 authors.

Tom Kai Ming WangCleveland Clinic Coordinating Center for Clinical Research (C5), Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Stephen J NichollsMonash Cardiovascular Research Centre, Melbourne, Victoria, Australia.
Clement TanCleveland Clinic Coordinating Center for Clinical Research (C5), Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Becky Yi-Wen LiaoSection of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
Kathy WolskiCleveland Clinic Coordinating Center for Clinical Research (C5), Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Julie St JohnCleveland Clinic Coordinating Center for Clinical Research (C5), Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.
Steven E NissenCleveland Clinic Coordinating Center for Clinical Research (C5), Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, 44195, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Fish oils are associated with higher risk of incident atrial fibrillation (AF) in randomized trials, risk factors for this remain unknown. We analyzed associated factors and developed a novel risk score for predicting AF in patients at elevated cardiovascular risk in this secondary analysis of the STRENGTH trial. Methods: The STRENGTH trial randomized 13,078 patients at high cardiovascular risk at 1:1 ratio to receive either ω-3 carboxylic acid (CA) or corn oil placebo at 675 centers during 10/30/2014-6/14/2017. Multivariable Cox proportional hazards regression was performed to develop a risk score to help identify new AF during follow-up in the ω-3 CA group without prior history of AF. Results: Amongst 6000 ω-3 CA group and 6012 placebo group patients without history of AF, 126 (2.1 %) and 75 (1.2 %) developed AF, respectively, during mean follow-up of 3.5 ± 0.8 years. In the ω-3 CA arm, older age, males, higher body mass index, history of heart failure, diabetes on insulin, and elevated high-sensitivity C-reactive protein were independently associated with incident AF during follow-up. A novel risk score based on these six parameters predicted incident AF with c-index 0.72 in the ω-3 CA group, and 0.73 when applied to the placebo group. Conclusion: A novel risk score for predicting AF development in patients at elevated cardiovascular risk receiving ω-3 CA had moderate discriminative ability in both patients receiving ω-3 CA and placebo. Further research is necessary to externally validate our risk score and determine how it may guide AF management and prevention and improve clinical outcomes.

Indexed as

Atrial fibrillationCardiovascular eventsFish oilsRisk scoreω−3 fatty acids

Identifiers

PMID42395094
PMCPMC13325731

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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.