Metabolic Treatment with <i>L</i>-Carnitine in Acute Anterior ST Segment Elevation Myocardial Infarction

Abstract

Background: Administration of L-carnitine in patients with anterior acute myocardial infarction (AMI) prevents left ventricular remodeling. Current study was aimed to assess the effect of L-carnitine administration on mortality and heart failure in patients with anterior AMI. Methods: CEDIM 2 trial was a randomized, double-blind, multicenter, placebo-controlled trial planned to enroll 4,000 patients with acute anterior AMI. The trial was interrupted after the enrolment of 2,330 patients because of the lower than expected enrolment rate. The primary end point was a composite of death and heart failure at 6 months; 5-day mortality was the secondary end point. Results: During the 6-month follow-up, the primary end-point was not significantly different between the L-carnitine and placebo group (9.2 vs. 10.5%, p = 0.27). A reduction in mortality was seen in the L-carnitine arm on day 5 (secondary end-point) from randomization (HR = 0.61, 95% CI 0.37–0.98, p = 0.041). Conclusions: In CEDIM 2 trial L-carnitine therapy led to a reduction in early mortality (secondary end-point) without affecting the risk of death and heart failure at 6 months in patients with anterior AMI, leading to a non-significant finding with respect to the primary end-point.

l-Carnitine rescues ketamine-induced attenuated heart rate and MAPK (ERK) activity in zebrafish embryos

“…A significant improvement in mechanical recovery, measured as the heart rate-peak systolic pressure product, was observed in L-carnitine-perfused post-ischemic rat hearts along with a two-fold increase in glucose oxidation rate compared to controls [30] and in diabetic rat hearts [31,32]. There is a substantial literature describing the clinical efficacy of L-carnitine in patients affected by heart disease [33][34][35][36]. Moreover, L-carnitine has been shown to ameliorate the ketamineinduced behavioral alterations and body weight deficits in developing rats [37], in addition to having neuroprotective abilities [38].…”

Роль Та Місце Кардіопротекції З Використанням Сучасних Інфузійних Препаратів У періопераційному Періоді

“…[55] виявили, що введення L-карнітину протягом 8 го-дин після появи симптомів зменшує поширеність ГІМ. В іншому плацебо-контрольованому рандо-мізованому дослідженні (101 пацієнт) [63] введення L-карнітину (2 г/добу) до 28-го дня від початку ГІМ забезпечувало вірогідно менші рівні креатинфосфо-кінази (КФК) і її фракції КФК-МВ, ніж на фоні при-йому плацебо. Раніше ще одне плацебо-контрольо-ване рандомізоване клінічне дослідження CEDIM виявило можливість впливу L-карнітину на процес розширення лівого шлуночка серця у 472 хворих на ГІМ передньої локалізації [48].…”

Effects of Therapeutic Lifestyle Change Diet and Q10 Plus L-Carnitine Supplementation on Inflammatory Biomarkers of In-Stent Restenosis, Lipid Profile, and Left Ventricular Ejection Fraction in Myocardial Infarction: A Randomized Clinical Trial

“…There are conflicting research results about the effects of Q10 and LC on inflammatory markers (21)(22)(23), lipid profiles (24,25), and LVEF (26,27). Although coenzyme Q10 supplementation has been found to affect inflammatory markers in healthy subjects, few clinical studies have investigated the relation between coenzyme Q10 and inflammation in patients with MI.…”