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Table 3 Subgroup estimation of the effects of fish oil supplementation on TNF-α and IL-6 in patients with CHF

From: Effects of fish oil supplementation on inflammatory markers in chronic heart failure: a meta-analysis of randomized controlled trials

  TNF-α IL-6
Subgroup Study arms (n)/patients (n) SMD [95% CI] p Study arms (n)/patients (n) SMD (95% CI) p
Age       
≤ 60 years 3/57 -0.47 [-1.22, 0.27]   2/43 -0.80 [-1.45, -0.15]  
> 60 years 4/285 -0.68 [-1.28, -0.08] 0.67 4/285 -0.81 [-1.72, 0.10] 0.99
Gender (male)       
≤ 90% 4/244 -0.76 [-1.48, -0.03]   3/230 -1.02 [-1.77, -0.28]  
> 90% 3/98 -0.44 [-0.87, -0.02] 0.46 3/98 -0.60 [-1.92, 0.72] 0.58
Ischemic CHF       
Not excluded 3/125 -0.42 [-0.94, 0.09]   2/111 -0.05 [-1.17, 1.07]  
Excluded 4/217 -0.71 [-1.34, -0.07] 0.50 4/217 -1.33 [-1.74, -0.92] 0.06
Baseline NYHA (class IV)       
Not included 3/249 -0.85 [-1.51, -0.18]   3/249 -1.23 [-1.93, -0.54]  
Included 3/57 -0.47 [-1.22, 0.27] 0.47 2/43 -0.80 [-1.45, -0.15] 0.37
Baseline LVEF       
≤ 30% 3/57 -0.47 [-1.22, 0.27]   2/43 -0.80 [-1.45, -0.15]  
> 30% 3/249 -0.85 [-1.51, -0.18] 0.47 3/249 -1.23 [-1.93, -0.54] 0.37
Baseline TNF-α       
≤ 10 pg/ml 4/93 -0.33 [-0.82, 0.17]   
> 10 pg/ml 3/249 -0.85 [-1.51, -0.18] 0.22
Baseline IL-6       
≤ 5 pg/ml   3/79 -0.31 [-1.27, 0.65]  
> 5 pg/ml 3/249 -1.23 [-1.93, -0.54] 0.13
ACEI/ARB       
Not all used 1/14 -1.41 [-2.62, -0.19]   0/0  
All used 5/292 -0.62 [-1.17, -0.08] 0.25 5/292 -1.10 [-1.60, -0.60]
β-blockers       
Not all used 3/125 -0.42 [-0.94, 0.09]   2/111 -0.05 [-1.17, 1.07]  
All used 4/217 -0.71 [-1.34, -0.07] 0.50 4/217 -1.33 [-1.74, -0.92] 0.06
EPA + DHA       
≤ 1000 mg/d 3/133 -0.23 [-0.57, 0.11]   3/133 -0.26 [-1.06, 0.54]  
> 1000 mg/d 4/209 -1.01 [-1.50, -0.53] 0.01 3/195 -1.47 [-1.84, -1.11] 0.007
EPA       
≤ 800 mg/d 4/266 -0.51 [-1.20, 0.19]   4/266 -0.62 [-1.54, 0.29]  
> 800 mg/d 3/76 -0.76 [-1.25, -0.27] 0.56 2/62 -1.25 [-1.93, -0.56] 0.28
DHA       
≤ 1300 mg/d 4/266 -0.51 [-1.20, 0.19]   4/266 -0.62 [-1.54, 0.29]  
> 1300 mg/d 3/76 -0.76 [-1.25, -0.27] 0.56 2/62 -1.25 [-1.93, -0.56] 0.28
EPA DHA ratio       
≤ 1 3/210 -0.80 [-1.53, -0.07]   3/210 -0.88 [-2.20, 0.44]  
> 1 4/132 -0.38 [-0.79, 0.03] 0.32 3/118 -0.66 [-1.04, -0.29] 0.76
Duration       
≤ 4 months 5/168 -0.32 [-0.63, -0.01]   4/154 -0.38 [-1.02, 0.26]  
> 4 months 2/174 -1.15 [-1.67, -0.62] 0.008 2/174 -1.59 [-1.93, -1.25] 0.001
Quality score       
≤ 3 5/299 -0.77 [-1.32, -0.22]   4/285 -0.81 [-1.72, 0.10]  
> 3 2/43 -0.16 [-0.78, 0.46] 0.15 2/43 -0.80 [-1.45, -0.15] 0.99
  1. p difference between strata (Student’s t test).
  2. TNF-α, tumor necrosis factor α; IL-6, interleukin 6; CHF, chronic heart failure; NYHA, New York Heart Association; LVEF, left ventricular ejection fraction; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor inhibitor; EPA, eicosapentaenoic acid; DHA, ducosahexenoic acid; SMD, standardized mean difference; CI, confidence interval.