Fish oil and aspirin effects on arteriovenous fistula function: Secondary outcomes of the randomised omega-3 fatty acids (Fish oils) and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) trial

Omega-3 Fatty Acids Fish Oils

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Abstract

Background

Arteriovenous fistulas (AVF) for haemodialysis often experience early thrombosis and maturation failure requiring intervention and/or central venous catheter (CVC) placement. This secondary and exploratory analysis of the FAVOURED study determined whether omega-3 fatty acids (fish oils) or aspirin affected AVF usability, intervention rates and CVC requirements.

Methods

In 567 adult participants planned for AVF creation, all were randomised to fish oil (4g/d) or placebo, and 406 to aspirin (100mg/d) or placebo, starting one day pre-surgery and continued for three months. Outcomes evaluated within 12 months included AVF intervention rates, CVC exposure, late dialysis suitability failure, and times to primary patency loss, abandonment and successful cannulation.

Results

Final analyses included 536 participants randomised to fish oil or placebo (mean age 55 years, 64% male, 45% diabetic) and 388 randomised to aspirin or placebo. Compared with placebo, fish oil reduced intervention rates (0.82 vs 1.14/1000 patient-days, incidence rate ratio [IRR] 0.72, 95% confidence interval [CI] 0.54-0.97), particularly interventions for acute thrombosis (0.09 vs 0.17/1000 patient-days, IRR 0.53, 95% CI 0.34-0.84). Aspirin significantly reduced rescue intervention rates (IRR 0.45, 95% CI 0.27-0.78). Neither agent significantly affected CVC exposure, late dialysis suitability failure or time to primary patency loss, AVF abandonment or successful cannulation.

Conclusion

Although fish oil and low-dose aspirin given for 3 months reduced intervention rates in newly created AVF, they had no significant effects on CVC exposure, AVF usability and time to primary patency loss or access abandonment. Reduction in access interventions benefits patients, reduces costs and warrants further study.

Original languageEnglish
Article numbere0213274
Number of pages20
JournalPLoS One
Volume14
Issue number3
DOIs
Publication statusPublished - 26 Mar 2019

Cite this

@article{45ac72d7bd9b472c89cccdf68f0ff9a9,
title = "Fish oil and aspirin effects on arteriovenous fistula function: Secondary outcomes of the randomised omega-3 fatty acids (Fish oils) and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) trial",
abstract = "BackgroundArteriovenous fistulas (AVF) for haemodialysis often experience early thrombosis and maturation failure requiring intervention and/or central venous catheter (CVC) placement. This secondary and exploratory analysis of the FAVOURED study determined whether omega-3 fatty acids (fish oils) or aspirin affected AVF usability, intervention rates and CVC requirements.MethodsIn 567 adult participants planned for AVF creation, all were randomised to fish oil (4g/d) or placebo, and 406 to aspirin (100mg/d) or placebo, starting one day pre-surgery and continued for three months. Outcomes evaluated within 12 months included AVF intervention rates, CVC exposure, late dialysis suitability failure, and times to primary patency loss, abandonment and successful cannulation.ResultsFinal analyses included 536 participants randomised to fish oil or placebo (mean age 55 years, 64{\%} male, 45{\%} diabetic) and 388 randomised to aspirin or placebo. Compared with placebo, fish oil reduced intervention rates (0.82 vs 1.14/1000 patient-days, incidence rate ratio [IRR] 0.72, 95{\%} confidence interval [CI] 0.54-0.97), particularly interventions for acute thrombosis (0.09 vs 0.17/1000 patient-days, IRR 0.53, 95{\%} CI 0.34-0.84). Aspirin significantly reduced rescue intervention rates (IRR 0.45, 95{\%} CI 0.27-0.78). Neither agent significantly affected CVC exposure, late dialysis suitability failure or time to primary patency loss, AVF abandonment or successful cannulation.ConclusionAlthough fish oil and low-dose aspirin given for 3 months reduced intervention rates in newly created AVF, they had no significant effects on CVC exposure, AVF usability and time to primary patency loss or access abandonment. Reduction in access interventions benefits patients, reduces costs and warrants further study.",
author = "{Omega-3 Fatty Acids Fish Oils} and Viecelli, {Andrea K.} and Polkinghorne, {Kevan R.} and Elaine Pascoe and Peta-Anne Paul-Brent and Carmel Hawley and Badve, {Sunil V.} and Alan Cass and Lai-Seong Hooi and Kerr, {Peter G.} and Mori, {Trevor A.} and Loke-Meng Ong and David Voss and Johnson, {David W.} and Irish, {Ashley B.} and Peh, {Chen Au} and Elaine Beller and Sharan Dogra and David Gracey and Elvie Haluszkiewicz and Carmel Hawley and Colin Hutchison and Ashley Irish and Peter Kerr and Amanda Mather and Stephen McDonald and Chris McIntyre and Trevor Mori and Elaine Pascoe and Kevan Polkinghorne and Amanda Robertson and Johan Rosman and Andrew Forbes and Adeera Levin and Wheeler, {David C.}",
year = "2019",
month = "3",
day = "26",
doi = "10.1371/journal.pone.0213274",
language = "English",
volume = "14",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "3",

}

Fish oil and aspirin effects on arteriovenous fistula function : Secondary outcomes of the randomised omega-3 fatty acids (Fish oils) and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) trial. / Omega-3 Fatty Acids Fish Oils.

In: PLoS One, Vol. 14, No. 3, e0213274, 26.03.2019.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Fish oil and aspirin effects on arteriovenous fistula function

T2 - Secondary outcomes of the randomised omega-3 fatty acids (Fish oils) and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED) trial

AU - Omega-3 Fatty Acids Fish Oils

AU - Viecelli, Andrea K.

AU - Polkinghorne, Kevan R.

AU - Pascoe, Elaine

AU - Paul-Brent, Peta-Anne

AU - Hawley, Carmel

AU - Badve, Sunil V.

AU - Cass, Alan

AU - Hooi, Lai-Seong

AU - Kerr, Peter G.

AU - Mori, Trevor A.

AU - Ong, Loke-Meng

AU - Voss, David

AU - Johnson, David W.

AU - Irish, Ashley B.

AU - Peh, Chen Au

AU - Beller, Elaine

AU - Dogra, Sharan

AU - Gracey, David

AU - Haluszkiewicz, Elvie

AU - Hawley, Carmel

AU - Hutchison, Colin

AU - Irish, Ashley

AU - Kerr, Peter

AU - Mather, Amanda

AU - McDonald, Stephen

AU - McIntyre, Chris

AU - Mori, Trevor

AU - Pascoe, Elaine

AU - Polkinghorne, Kevan

AU - Robertson, Amanda

AU - Rosman, Johan

AU - Forbes, Andrew

AU - Levin, Adeera

AU - Wheeler, David C.

PY - 2019/3/26

Y1 - 2019/3/26

N2 - BackgroundArteriovenous fistulas (AVF) for haemodialysis often experience early thrombosis and maturation failure requiring intervention and/or central venous catheter (CVC) placement. This secondary and exploratory analysis of the FAVOURED study determined whether omega-3 fatty acids (fish oils) or aspirin affected AVF usability, intervention rates and CVC requirements.MethodsIn 567 adult participants planned for AVF creation, all were randomised to fish oil (4g/d) or placebo, and 406 to aspirin (100mg/d) or placebo, starting one day pre-surgery and continued for three months. Outcomes evaluated within 12 months included AVF intervention rates, CVC exposure, late dialysis suitability failure, and times to primary patency loss, abandonment and successful cannulation.ResultsFinal analyses included 536 participants randomised to fish oil or placebo (mean age 55 years, 64% male, 45% diabetic) and 388 randomised to aspirin or placebo. Compared with placebo, fish oil reduced intervention rates (0.82 vs 1.14/1000 patient-days, incidence rate ratio [IRR] 0.72, 95% confidence interval [CI] 0.54-0.97), particularly interventions for acute thrombosis (0.09 vs 0.17/1000 patient-days, IRR 0.53, 95% CI 0.34-0.84). Aspirin significantly reduced rescue intervention rates (IRR 0.45, 95% CI 0.27-0.78). Neither agent significantly affected CVC exposure, late dialysis suitability failure or time to primary patency loss, AVF abandonment or successful cannulation.ConclusionAlthough fish oil and low-dose aspirin given for 3 months reduced intervention rates in newly created AVF, they had no significant effects on CVC exposure, AVF usability and time to primary patency loss or access abandonment. Reduction in access interventions benefits patients, reduces costs and warrants further study.

AB - BackgroundArteriovenous fistulas (AVF) for haemodialysis often experience early thrombosis and maturation failure requiring intervention and/or central venous catheter (CVC) placement. This secondary and exploratory analysis of the FAVOURED study determined whether omega-3 fatty acids (fish oils) or aspirin affected AVF usability, intervention rates and CVC requirements.MethodsIn 567 adult participants planned for AVF creation, all were randomised to fish oil (4g/d) or placebo, and 406 to aspirin (100mg/d) or placebo, starting one day pre-surgery and continued for three months. Outcomes evaluated within 12 months included AVF intervention rates, CVC exposure, late dialysis suitability failure, and times to primary patency loss, abandonment and successful cannulation.ResultsFinal analyses included 536 participants randomised to fish oil or placebo (mean age 55 years, 64% male, 45% diabetic) and 388 randomised to aspirin or placebo. Compared with placebo, fish oil reduced intervention rates (0.82 vs 1.14/1000 patient-days, incidence rate ratio [IRR] 0.72, 95% confidence interval [CI] 0.54-0.97), particularly interventions for acute thrombosis (0.09 vs 0.17/1000 patient-days, IRR 0.53, 95% CI 0.34-0.84). Aspirin significantly reduced rescue intervention rates (IRR 0.45, 95% CI 0.27-0.78). Neither agent significantly affected CVC exposure, late dialysis suitability failure or time to primary patency loss, AVF abandonment or successful cannulation.ConclusionAlthough fish oil and low-dose aspirin given for 3 months reduced intervention rates in newly created AVF, they had no significant effects on CVC exposure, AVF usability and time to primary patency loss or access abandonment. Reduction in access interventions benefits patients, reduces costs and warrants further study.

UR - http://www.scopus.com/inward/record.url?scp=85063481480&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0213274

DO - 10.1371/journal.pone.0213274

M3 - Article

VL - 14

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 3

M1 - e0213274

ER -