Fish Consumption and Acute Coronary Syndrome: A Meta-Analysis | Journal Scan

Study Questions:

What is the relationship between fish consumption and an acute coronary syndrome (ACS)?


The authors conducted a literature search of MEDLINE and Embase databases from 1966 to June 2013 for prospective cohort and case-control studies that evaluated the association between fish consumption and ACS among general populations without cardiovascular disease history. Estimates of relative risk (RR) were pooled using random-effects model.


There were 11 prospective cohort and eight case-control studies, totaling 408,305 participants. Among prospective cohort studies, the highest category of fish consumption (i.e., 4 times per week) was associated with the greatest risk reduction in ACS (RR, 0.79; 95% confidence interval [CI], 0.70-0.89). In dose-response analysis, each additional 100-g serving of fish per week was associated with a 5% reduced risk (RR per serving, 0.95; 95% CI, 0.92-0.97). Subgroup analysis and meta-regression suggested that the risk reduction did not differ across sex or age groups. No heterogeneity was observed among prospective cohort (p = 0.73) and case-control (p = 0.29) studies. There was no evidence of publication bias.


The meta-analysis demonstrated that there is an inverse association between fish consumption and the risk of ACS. Fish consumption appears beneficial in the primary prevention of ACS, and higher consumption is associated with greater protection.


The evidence for the benefit of fish oil supplements has not been supportable in the modern era of statins, aspirin, and beta-blockers. While the benefit of consuming fish as a healthy food group, particularly in place of meat choices, is clear, to what degree fish is therapeutically beneficial in the modern era is not clear.

Clinical Topics: Acute Coronary Syndromes, Dyslipidemia, Prevention, Lipid Metabolism, Nonstatins

Keywords: Acute Coronary Syndrome, Risk Reduction Behavior, Fish Oils, MEDLINE, Primary Prevention

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