Omega-3 fatty acids in high-risk cardiovascular patients: a meta-analysis of randomized controlled trials

<p>Abstract</p> <p>Background</p> <p>Multiple randomized controlled trials (RCTs) have examined the cardiovascular effects of omega-3 fatty acids and have provided unexplained conflicting results. A meta-analysis of these RCTs to estimate efficacy and safety and potential sources of heterogeneity may be helpful.</p> <p>Methods</p> <p>The Cochrane library, MEDLINE, and EMBASE were systematically searched to identify all interventional trials of omega-3 fatty acids compared to placebo or usual diet in high-risk cardiovascular patients. The primary outcome was all-cause mortality and secondary outcomes were coronary restenosis following percutaneous coronary intervention and safety. Meta-analyses were carried out using Bayesian random-effects models, and heterogeneity was examined using meta-regression.</p> <p>Results</p> <p>A total of 29 RCTs (n = 35,144) met our inclusion criteria, with 25 reporting mortality and 14 reporting restenosis. Omega-3 fatty acids were not associated with a statistically significant decreased mortality (relative risk [RR] = 0.88, 95% Credible Interval [CrI] = 0.64, 1.03) or with restenosis prevention (RR = 0.89, 95% CrI = 0.72, 1.06), though the probability of some benefit remains high (0.93 and 0.90, respectively). However in meta-regressions, there was a >90% probability that larger studies and those with longer follow-up were associated with smaller benefits. No serious safety issues were identified.</p> <p>Conclusions</p> <p>Although not reaching conventional statistical significance, the evidence to date suggests that omega-3 fatty acids may result in a modest reduction in mortality and restenosis. However, caution must be exercised in interpreting these benefits as results were attenuated in higher quality studies, suggesting that bias may be at least partially responsible. Additional high quality studies are required to clarify the role of omega-3 fatty acid supplementation for the secondary prevention of cardiovascular disease.</p

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary.

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Intersexuality and Trans-Identities within the Diversity Management Discourse

Within both the scientific discourse on workforce diversity, and diversity management practice, intersexuality and transgender issues have hitherto remained marginalized topics. This chapter gives an overview of the discourses on both phenomena, and proposes starting points for more inclusive organizational diversity management initiatives. It is shown that both topics represent different aspects of the category of "gender". The common practice of conceptually lumping together intersexuality, transgenderism, and sexual orientation can be seen as one important reason that intersexuality and transgenderism are rarely considered in organizational diversity management programs in terms of concrete action. Against this background, a modified, and more integrated approach to structuring the workforce alongside the different dimensions of diversity is proposed. It is shown that the categories of "biological sex and gender", "gender identity", and "sexual orientation" cannot be regarded as being separate from each other. They represent, rather, an interrelated organizational field of action that should be considered as being one interrelated topic for organizational diversity practices. This chapter derives this claim theoretically and discusses the consequences for organizational diversity management practices. For most organizations, this would mean a fundamental rethinking of their goals, in terms of workforce diversity, and the shaping of their diversity management programs