{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T19:11:57Z","timestamp":1791573117690,"version":"4.3.4"},"reference-count":80,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>The effect of marine omega-3 PUFAs on risk of stroke remains unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>We investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual-level analysis using a prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Among 183\u2005291 study participants, there were 10\u2005561 total strokes, 8220 ischemic strokes, and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76\u20130.91];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74\u20130.91];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001). For docosahexaenoic acid, comparing Q5 with Q1, there was a 12% lower incidence of total stroke (HR, 0.88 [CI, 0.81\u20130.96];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78\u20130.95];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              =0.0001). Neither eicosapentaenoic acid nor docosahexaenoic acid was associated with a risk for hemorrhagic stroke. These associations were not modified by either baseline history of AF or prevalent CVD.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.123.044281","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T19:00:45Z","timestamp":1703271645000},"page":"50-58","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":46,"title":["Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183\u2009291 Participants From 29 Prospective Studies"],"prefix":"10.1161","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3376-5822","authenticated-orcid":true,"given":"James H.","family":"O\u2019Keefe","sequence":"first","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute, University of Missouri-Kansas City (J.H.O., E.L.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan L.","family":"Tintle","sequence":"additional","affiliation":[{"name":"Fatty Acid Research Institute (N.L.T., W.S.H., A.S.-V., J.W.), Sioux Falls, SD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William S.","family":"Harris","sequence":"additional","affiliation":[{"name":"Fatty Acid Research Institute (N.L.T., W.S.H., A.S.-V., J.W.), Sioux Falls, SD."},{"name":"University of South Dakota (W.S.H.), Sioux Falls, SD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2746-2323","authenticated-orcid":true,"given":"Evan L.","family":"O\u2019Keefe","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute, University of Missouri-Kansas City (J.H.O., E.L.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleix","family":"Sala-Vila","sequence":"additional","affiliation":[{"name":"Fatty Acid Research Institute (N.L.T., W.S.H., A.S.-V., J.W.), Sioux Falls, SD."},{"name":"Hospital del Mar Medical Research Institute, Barcelona, Spain (A.S.-V., I.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9800-1308","authenticated-orcid":true,"given":"John","family":"Attia","sequence":"additional","affiliation":[{"name":"The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia (J. Attia, G.M.G., A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0514-0865","authenticated-orcid":true,"given":"G. Manohar","family":"Garg","sequence":"additional","affiliation":[{"name":"The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia (J. Attia, G.M.G., A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2225-0986","authenticated-orcid":true,"given":"Alexis","family":"Hure","sequence":"additional","affiliation":[{"name":"The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia (J. Attia, G.M.G., A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5233-2902","authenticated-orcid":true,"given":"Christian S\u00f8rensen","family":"Bork","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital, Denmark (C.S.B.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0623-5666","authenticated-orcid":true,"given":"Erik Berg","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine (E.B.S.), Aalborg University Hospital, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stine Krogh","family":"Ven\u00f8","sequence":"additional","affiliation":[{"name":"Department of Clinical Biochemistry (S.K.V.), Aalborg University Hospital, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4979-8351","authenticated-orcid":true,"given":"Kuo-Liong","family":"Chien","sequence":"additional","affiliation":[{"name":"National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei (K.-L.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7009-7838","authenticated-orcid":true,"given":"Yun-Yu (Amelia)","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Taichung Veterans General Hospital, Taiwan (Y.-Y.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Egert","sequence":"additional","affiliation":[{"name":"Institute of Nutrition and Food Sciences and Nutritional Physiology, University of Bonn, Germany (S.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias Rudholm","family":"Feldreich","sequence":"additional","affiliation":[{"name":"Dalarna University, School of Health and Welfare, Falun, Sweden (T.R.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6933-4637","authenticated-orcid":true,"given":"Johan","family":"\u00c4rnl\u00f6v","sequence":"additional","affiliation":[{"name":"Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Solna, Sweden (J. \u00c4rnl\u00f6v)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2335-8542","authenticated-orcid":true,"given":"Lars","family":"Lind","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Cardiovascular Epidemiology, Uppsala University, Sweden (L.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5041-248X","authenticated-orcid":true,"given":"Nita G.","family":"Forouhi","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, United Kingdom (N.G.F., F.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7638-0589","authenticated-orcid":true,"given":"Johanna M.","family":"Geleijnse","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands (J.M.G., K.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2861-9051","authenticated-orcid":true,"given":"Kamalita","family":"Pertiwi","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition and Health, Wageningen University and Research, the Netherlands (J.M.G., K.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6841-8396","authenticated-orcid":true,"given":"Fumiaki","family":"Imamura","sequence":"additional","affiliation":[{"name":"MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, United Kingdom (N.G.F., F.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3414-6983","authenticated-orcid":true,"given":"Vanessa","family":"de Mello Laaksonen","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition (V.d.M.L., W.M.U., J.T., M.A.L., J.V.), School of Medicine, University of Eastern Finland, Kuopio, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6052-2001","authenticated-orcid":true,"given":"W. Matti","family":"Uusitupa","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition (V.d.M.L., W.M.U., J.T., M.A.L., J.V.), School of Medicine, University of Eastern Finland, Kuopio, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3424-0745","authenticated-orcid":true,"given":"Jaakko","family":"Tuomilehto","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition (V.d.M.L., W.M.U., J.T., M.A.L., J.V.), School of Medicine, University of Eastern Finland, Kuopio, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3394-7749","authenticated-orcid":true,"given":"Markku","family":"Laakso","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine (M.L.), School of Medicine, University of Eastern Finland, Kuopio, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9158-283X","authenticated-orcid":true,"given":"Maria Anneli","family":"Lankinen","sequence":"additional","affiliation":[{"name":"Institute of Public Health and Clinical Nutrition (V.d.M.L., W.M.U., J.T., M.A.L., J.V.), School of Medicine, University of Eastern Finland, Kuopio, Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5032-2452","authenticated-orcid":true,"given":"Danielle","family":"Laurin","sequence":"additional","affiliation":[{"name":"CHU de Qu\u00e9bec-Universit\u00e9 Laval and VITAM Research Centers, Centre d\u2019Excellence sur le Vieillissement de Qu\u00e9bec, Canada (D.L., P.-H.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5324-862X","authenticated-orcid":true,"given":"Pierre-Hugues","family":"Carmichael","sequence":"additional","affiliation":[{"name":"CHU de Qu\u00e9bec-Universit\u00e9 Laval and VITAM Research Centers, Centre d\u2019Excellence sur le Vieillissement de Qu\u00e9bec, Canada (D.L., P.-H.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Lindsay","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health, University of Ottawa, Canada (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1404-9222","authenticated-orcid":true,"given":"Karin","family":"Leander","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden (K.L., F.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3551-1348","authenticated-orcid":true,"given":"Federica","family":"Laguzzi","sequence":"additional","affiliation":[{"name":"Karolinska Institutet, Institute of Environmental 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