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@ARTICLE{OKeefe:266761,
      author       = {O'Keefe, James H and Tintle, Nathan L and Harris, William S
                      and O'Keefe, Evan L and Sala-Vila, Aleix and Attia, John and
                      Garg, G Manohar and Hure, Alexis and Bork, Christian
                      Sørensen and Schmidt, Erik Berg and Venø, Stine Krogh and
                      Chien, Kuo-Liong and Chen, Yun-Yu Amelia and Egert, Sarah
                      and Feldreich, Tobias Rudholm and Ärnlöv, Johan and Lind,
                      Lars and Forouhi, Nita G and Geleijnse, Johanna M and
                      Pertiwi, Kamalita and Imamura, Fumiaki and de Mello
                      Laaksonen, Vanessa and Uusitupa, W Matti and Tuomilehto,
                      Jaakko and Laakso, Markku and Lankinen, Maria Anneli and
                      Laurin, Danielle and Carmichael, Pierre-Hugues and Lindsay,
                      Joan and Leander, Karin and Laguzzi, Federica and Swenson,
                      Brenton R and Longstreth, William T and Manson, JoAnn E and
                      Mora, Samia and Cook, Nancy R and Marklund, Matti and Melo
                      van Lent, Debora and Murphy, Rachel and Gudnason, Vilmundur
                      and Ninomiya, Toshihara and Hirakawa, Yoichiro and Qian,
                      Frank and Sun, Qi and Hu, Frank and Ardisson Korat, Andres V
                      and Risérus, Ulf and Lázaro, Iolanda and Samieri, Cecilia
                      and Le Goff, Mélanie and Helmer, Catherine and Steur,
                      Marinka and Voortman, Trudy and Ikram, M Kamran and Tanaka,
                      Toshiko and Das, Jayanta K and Ferrucci, Luigi and
                      Bandinelli, Stefania and Tsai, Michael and Guan, Weihua and
                      Garg, Parveen and Verschuren, W M Monique and Boer, Jolanda
                      M A and Biokstra, Anneke and Virtanen, Jyrki and Wagner,
                      Michael and Westra, Jason and Albuisson, Luc and Yamagishi,
                      Kazumasa and Siscovick, David S and Lemaitre, Rozenn N and
                      Mozaffarian, Dariush},
      title        = {{O}mega-3 {B}lood {L}evels and {S}troke {R}isk: {A}
                      {P}ooled and {H}armonized {A}nalysis of 183 291
                      {P}articipants {F}rom 29 {P}rospective {S}tudies.},
      journal      = {Stroke},
      volume       = {55},
      number       = {1},
      issn         = {0039-2499},
      address      = {Philadelphia, Pa.},
      publisher    = {Lippincott Williams $\&$ Wilkins},
      reportid     = {DZNE-2024-00024},
      pages        = {50 - 58},
      year         = {2024},
      abstract     = {The effect of marine omega-3 PUFAs on risk of stroke
                      remains unclear.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.Among
                      183 291 study participants, there were 10 561 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, 0.76-0.91]; P<0.0001), and ischemic stroke was
                      $18\%$ lower (HR, 0.82 [CI, 0.74-0.91]; P<0.0001). For
                      docosahexaenoic acid, comparing Q5 with Q1, there was a
                      $12\%$ lower incidence of total stroke (HR, 0.88 [CI,
                      0.81-0.96]; P=0.0001) and a $14\%$ lower incidence of
                      ischemic stroke (HR, 0.86 [CI, 0.78-0.95]; P=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.Higher omega-3 PUFA levels are
                      associated with lower risks of total and ischemic stroke but
                      have no association with hemorrhagic stroke.},
      keywords     = {Humans / Prospective Studies / Eicosapentaenoic Acid /
                      Docosahexaenoic Acids / Hemorrhagic Stroke: epidemiology /
                      Fatty Acids, Omega-3 / Stroke: epidemiology / Ischemic
                      Stroke / Risk Factors / atrial fibrillation (Other) /
                      cerebrovascular disease (Other) / fish (Other) / fish oil
                      (Other) / stroke (Other) / Eicosapentaenoic Acid (NLM
                      Chemicals) / Docosahexaenoic Acids (NLM Chemicals) / Fatty
                      Acids, Omega-3 (NLM Chemicals)},
      cin          = {AG Wagner},
      ddc          = {610},
      cid          = {I:(DE-2719)1011201},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pmc          = {pmc:PMC10840378},
      pubmed       = {pmid:38134264},
      doi          = {10.1161/STROKEAHA.123.044281},
      url          = {https://pub.dzne.de/record/266761},
}