Randomized Trial of Carnitine for the Prevention of Perioperative Atrial Fibrillation

Dastan, Farzaneh; Talasaz, Azita Hajhossein; Mojtahedzadeh, Mojtaba; Karimi, Ali; Salehiomran, Abbas; Bina, Payvand; Jalali, Arash

doi:10.1053/j.semtcvs.2017.08.006

Cited by 15 publications

(8 citation statements)

References 33 publications

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“…According to a clinical trial conducted by Dastan et al . , administering 3 g of LC for a period of 4 days (2 days prior to surgery and 2 days after surgery) to patients undergoing coronary artery bypass graft surgery can significantly lower the incidence of arterial fibrillation and reduce serum CRP levels [ 24 ]. Original research by Derosa, et al .…”

Section: Discussionmentioning

confidence: 99%

The effects of L-carnitine supplementation on inflammation, oxidative stress, and clinical outcomes in critically Ill patients with sepsis: a randomized, double-blind, controlled trial

Keshani,

Alikiaii,

Babaei

et al. 2024

Nutr J

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Background Sepsis, a life-threatening organ dysfunction caused by a host’s dysregulated response to infection with an inflammatory process, becomes a real challenge for the healthcare systems. L-carnitine (LC) has antioxidant and anti-inflammatory properties as in previous studies. Thus, we aimed to determine the effects of LC on inflammation, oxidative stress, and clinical parameters in critically ill septic patients. Methods A randomized double-blinded controlled trial was conducted. A total of 60 patients were randomized to receive LC (3 g/day, n = 30) or placebo (n = 30) for 7 days. Inflammatory and oxidative stress parameters (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), superoxide dismutase (SOD), malondialdehyde (MDA), total antioxidant capacity (TAC), 28-day mortality rate, and some monitoring variables were evaluated. Results There was no statistically significant difference between study arms in baseline characteristics and disease severity scores. CRP (p < 0.001) and ESR (p: 0.004) significantly reduced, and SOD (p < 0.001) and TAC (p < 0.001) significantly improved in the LC group after 7 days. Between-group analysis revealed a significant reduction in CRP (p: 0.001) and serum chloride (p: 0.032), an increase in serum albumin (p: 0.036) and platelet (p: 0.004) significantly, and an increase in SOD marginally (p: 0.073). The 28-day mortality rate was also lower in the LC group compared with placebo (7 persons vs. 15 persons) significantly (odds ratio: 0.233, p: 0.010). Conclusions L-carnitine ameliorated inflammation, enhanced antioxidant defense, reduced mortality, and improved some clinical outcomes in critically ill patients with sepsis. Trial registration IRCT20201129049534N1; May 2021.

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Section: Discussionmentioning

confidence: 99%

The effects of L-carnitine supplementation on inflammation, oxidative stress, and clinical outcomes in critically Ill patients with sepsis: a randomized, double-blind, controlled trial

Keshani,

Alikiaii,

Babaei

et al. 2024

Nutr J

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“…Based on the correlation between carnitine and atrial brillation, Dastan et al [20] by evaluating the effect of carnitine administration on atrial brillation after coronary artery bypass grafting (CABG), found that Lcarnitine given before CABG reduced the incidence of atrial brillation after CABG. Similarly Shingu et al [21] found by retrospective analysis of 30 patients undergoing aortic valve surgery that the incidence of postoperative atrial brillation was signi cantly lower in 15 patients who received oral levocarnitine for 9 days (daily dose of 3 g) than in the control group (20% and 60%, respectively; P = 0.025).…”

Section: Discussionmentioning

confidence: 99%

Analysis of the relationship between plasma carnitine levels and non-valvular atrial fibrillation

Jiang

Zhao

Yang

et al. 2023

Preprint

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Objective To investigate the correlation between plasma carnitine levels and atrial fibrillation and its predictive value in atrial fibrillation by analyzing the changes of plasma carnitine levels in patients with atrial fibrillation (AF) by metabolomics methods. Methods The clinical data of consecutive patients with non-valvular atrial fibrillation admitted to the Second Hospital of Dalian Medical University from January 2020 to January 2022 and patients with sinus rhythm admitted for other reasons during the same period were collected, and the relationship between plasma carnitine levels and atrial fibrillation was investigated by analyzing the general clinical characteristics (including age, sex, blood pressure, blood lipids, body mass index, history of smoking, history of alcohol consumption, blood uric acid, left atrial internal diameter, history of hypertension, history of cerebral infarction, history of coronary artery disease) and laboratory test results such as plasma carnitine levels in both groups. Results In our study, a total of 195 patients were included in this study, including 90 patients in the atrial fibrillation group (including 45 patients with paroxysmal atrial fibrillation and 45 patients with persistent atrial fibrillation) and 105 patients in the sinus rhythm group. The plasma free carnitine CO, acetyl carnitine C2, propionyl carnitine C3, butyryl carnitine C4, isovaleryl carnitine C5, hydroxyisovaleryl carnitine C5-OH, palmitoyl carnitine C16, octadecanoyl carnitine C18, and 26-carbonyl carnitine C26 were significantly higher in the atrial fibrillation group than in the sinus rhythm group, and the differences were statistically significant (P < 0.05). The plasma acetylcarnitine C2, hydroxybutyrylcarnitine C4-OH, palmitoylcarnitine C16, and hydroxypalmitoylcarnitine C16:1-OH levels were significantly higher in the persistent AF group than in the paroxysmal AF group, and the differences were statistically significant (P < 0.05). Binary logistic regression analysis revealed that age, high-density lipoprotein, left atrial internal diameter, and free carnitine CO were independent risk factors for the development of atrial fibrillation. Conclusion Patients with atrial fibrillation have altered plasma levels of some carnitine, and the occurrence of atrial fibrillation may be related to disturbances in the metabolism of this part of carnitine. Free carnitine CO is an independent correlate of atrial fibrillation, and its elevated levels suggest that patients may be prone to atrial fibrillation.

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“…Concurrent reports on CARN administration to patients undergoing hemodialysis [105][106][107], or septic shock [108] or affected by coronary artery disease [109], or perioperative atrial fibrillation [110] found CARN-induced significant decrease in CRP or decreased mortality, as shown in Table 3. The relevance of CRP in inflammation and OS had been established in early studies [111], thus the adjuvant role of CARN in mitigating a number of proinflammatory conditions should be ascertained.…”

Section: Mitochondrial Nutrients: Action Mechanisms and Antioxidant Pmentioning

confidence: 91%

Potential roles of mitochondrial cofactors in the adjuvant mitigation of proinflammatory acute infections, as in the case of sepsis and COVID-19 pneumonia

et al. 2020

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Background The mitochondrial cofactors α-lipoic acid (ALA), coenzyme Q10 (CoQ10) and carnitine (CARN) play distinct and complementary roles in mitochondrial functioning, along with strong antioxidant actions. Also termed mitochondrial nutrients (MNs), these cofactors have demonstrated specific protective actions in a number of chronic disorders, as assessed in a well-established body of literature. Methods Using PubMed, the authors searched for articles containing information on the utilization of MNs in inflammatory disorders as assessed from in vitro and animal studies, and in clinical trials, in terms of exerting anti-inflammatory actions. Results The retrieved literature provided evidence relating acute pathologic conditions, such as sepsis and pneumonia, with a number of redox endpoints of biological and clinical relevance. Among these findings, both ALA and CARN were effective in counteracting inflammation-associated redox biomarkers, while CoQ10 showed decreased levels in proinflammatory conditions. MN-associated antioxidant actions were applied in a number of acute disorders, mostly using one MN. The body of literature assessing the safety and the complementary roles of MNs taken together suggests an adjuvant role of MN combinations in counteracting oxidative stress in sepsis and other acute disorders, including COVID-19-associated pneumonia. Conclusions The present state of art in the use of individual MNs in acute disorders suggests planning adjuvant therapy trials utilizing MN combinations aimed at counteracting proinflammatory conditions, as in the case of pneumonia and the COVID-19 pandemic.

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Randomized Trial of Carnitine for the Prevention of Perioperative Atrial Fibrillation

Cited by 15 publications

References 33 publications

The effects of L-carnitine supplementation on inflammation, oxidative stress, and clinical outcomes in critically Ill patients with sepsis: a randomized, double-blind, controlled trial

The effects of L-carnitine supplementation on inflammation, oxidative stress, and clinical outcomes in critically Ill patients with sepsis: a randomized, double-blind, controlled trial

Analysis of the relationship between plasma carnitine levels and non-valvular atrial fibrillation

Potential roles of mitochondrial cofactors in the adjuvant mitigation of proinflammatory acute infections, as in the case of sepsis and COVID-19 pneumonia

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