l-carnitine as an Adjunct Therapy to Percutaneous Coronary Intervention for Non-ST Elevation Myocardial Infarction

Xue, Yu-Zeng; Wang, Lexin; Liu, Huazhi; Qi, Xue-Wen; Wang, Xiaohua; Ren, Huajian

doi:10.1007/s10557-007-6056-9

Cited by 25 publications

(21 citation statements)

References 17 publications

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“…L-carnitine reduces early mortality but not overall risk of death or heart failure at 6 months [127]. L-carnitine supplementation also prevents ventricular enlargement and dysfunction, reduces the infarct size and cardiac biomarkers, and diminishes the total number of cardiac events including cardiac deaths and nonfatal infarction [128,129]. Xue and colleagues suggest that the beneficial effects of L-carnitine in cardiovascular disease are due to the resumption of normal oxidative metabolism and restoration of myocardial energy reserves [128,129].…”

Section: Introductionmentioning

confidence: 99%

Role of carnitine in disease

et al. 2010

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Carnitine is a conditionally essential nutrient that plays a vital role in energy production and fatty acid metabolism. Vegetarians possess a greater bioavailability than meat eaters. Distinct deficiencies arise either from genetic mutation of carnitine transporters or in association with other disorders such as liver or kidney disease. Carnitine deficiency occurs in aberrations of carnitine regulation in disorders such as diabetes, sepsis, cardiomyopathy, malnutrition, cirrhosis, endocrine disorders and with aging. Nutritional supplementation of L-carnitine, the biologically active form of carnitine, is ameliorative for uremic patients, and can improve nerve conduction, neuropathic pain and immune function in diabetes patients while it is life-saving for patients suffering primary carnitine deficiency. Clinical application of carnitine holds much promise in a range of neural disorders such as Alzheimer's disease, hepatic encephalopathy and other painful neuropathies. Topical application in dry eye offers osmoprotection and modulates immune and inflammatory responses. Carnitine has been recognized as a nutritional supplement in cardiovascular disease and there is increasing evidence that carnitine supplementation may be beneficial in treating obesity, improving glucose intolerance and total energy expenditure.

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Section: Introductionmentioning

confidence: 99%

Role of carnitine in disease

et al. 2010

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“…16 In patients with non-ST elevation MI, L-carnitine reduced the release of both creatine-MB and troponin-I. 17 However, the effect of L-carnitine on overall clinical outcome has not been determined. Other anti-oxidants such as α-lipoic acid (the level of which significantly declines with age) 18 and melatonin (an anti-oxidant and a neurohormone produced by the pineal gland) 19 are currently being tested in clinical trials for cardiovascular-related indications.…”

Section: Introductionmentioning

confidence: 99%

Mitochondrial Reactive Oxygen Species at the Heart of the Matter

Kornfeld

Hwang

Disatnik

et al. 2015

Circulation Research

176

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Reactive oxygen species (ROS) have been implicated in a variety of age-related diseases including multiple cardiovascular disorders. However, translation of ROS scavengers (anti-oxidants) into the clinic has not been successful. These anti-oxidants grossly reduce total levels of cellular ROS including ROS that participate in physiological signaling. In this review, we challenge the traditional anti-oxidant therapeutic approach that targets ROS directly with novel approaches that improve mitochondrial functions to more effectively treat cardiovascular diseases.

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“…In chronic heart disease patients, L-carnitine administration over 12 months has been shown to attenuate left ventricular dilatation and prevent ventricular remodeling while reducing incidence of chronic heart failure and death. The protective effects of L-carnitine supplementation also extend to acute myocardial infarction (MI); following acute MI, prompt L-carnitine administration and subsequent oral maintenance therapy has been shown to attenuate progressive left ventricular dilatation and appears to reduce myocardial injury through improving carbohydrate metabolism and reducing the toxicity of high free fatty acid levels [5,6]. A recent systematic review and meta-analysis of 13 controlled trials by DiNicolantonio et al found that L-carnitine supplementation was associated with a significant reduction in all-cause mortality, ventricular arrhythmia, and angina in the setting of acute MI [7].…”

Section: Introductionmentioning

confidence: 99%

Effective dosing of L-carnitine in the secondary prevention of cardiovascular disease: a systematic review and meta-analysis

Shang

Sun

2014

BMC Cardiovasc Disord

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BackgroundL-carnitine supplementation has been associated with a significant reduction in all-cause mortality, ventricular arrhythmia, and angina in the setting of acute myocardial infarction (MI). However, on account of strict homeostatic regulation of plasma L-carnitine concentrations, higher doses of L-carnitine supplementation may not provide additional therapeutic benefits. This study aims to evaluate the effects of various oral maintenance dosages of L-carnitine on all-cause mortality and cardiovascular morbidities in the setting of acute MI.MethodsAfter a systematic review of several major electronic databases (PubMed, EMBASE, and the Cochrane Library) up to November 2013, a meta-analysis of five controlled trials (n = 3108) was conducted to determine the effects of L-carnitine on all-cause mortality and cardiovascular morbidities in the setting of acute MI.ResultsThe interaction test yielded no significant differences between the effects of the four daily oral maintenance dosages of L-carnitine (i.e., 2 g, 3 g, 4 g, and 6 g) on all-cause mortality (risk ratio [RR] = 0.77, 95% CI [0.57-1.03], P = 0.08) with a statistically insignificant trend favoring the 3 g dose (RR = 0.48) over the lower 2 g dose (RR = 0.62), which was favored over the higher 4 g and 6 g doses (RR = 0.78, 0.78). There was no significant differences between the effects of the daily oral maintenance dosages of 2 g and 6 g on heart failure (RR = 0.53, 95% CI [0.25-1.13], P = 0.10), unstable angina (RR = 0.90, 95% CI [0.51-1.58], P = 0.71), or myocardial reinfarction (RR = 0.74, 95% CI [0.30-1.80], P = 0.50).ConclusionsThere appears to be no significant marginal benefit in terms of all-cause mortality, heart failure, unstable angina, or myocardial reinfarction in the setting of acute MI for oral L-carnitine maintenance doses of greater or less than 3 g per day.

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l-carnitine as an Adjunct Therapy to Percutaneous Coronary Intervention for Non-ST Elevation Myocardial Infarction

Abstract: L: -carnitine adjunct therapy appears to be associated with a reduced level of cardiac markers in patients with NSTEMI. These results support a larger clinical trial to investigate the effect of L: -carnitine on cardiac events following PCI.

Cited by 25 publications

References 17 publications

Role of carnitine in disease

Role of carnitine in disease

Mitochondrial Reactive Oxygen Species at the Heart of the Matter

Effective dosing of L-carnitine in the secondary prevention of cardiovascular disease: a systematic review and meta-analysis

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