L-Carnitine in the secondary prevention of cardiovascular disease: Systematic review and meta-analysis

DiNicolantonio, James J., Lavie, Carl J., Fares, Hassan, Menezes, Arthur R. and O'Keefe, James H. (2013) L-Carnitine in the secondary prevention of cardiovascular disease: Systematic review and meta-analysis. Mayo Clinic Proceedings, 88 6: 544-551. doi:10.1016/j.mayocp.2013.02.007


Author DiNicolantonio, James J.
Lavie, Carl J.
Fares, Hassan
Menezes, Arthur R.
O'Keefe, James H.
Title L-Carnitine in the secondary prevention of cardiovascular disease: Systematic review and meta-analysis
Journal name Mayo Clinic Proceedings   Check publisher's open access policy
ISSN 0025-6196
1942-5546
Publication date 2013-06
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1016/j.mayocp.2013.02.007
Volume 88
Issue 6
Start page 544
End page 551
Total pages 8
Place of publication New York, United States
Publisher Elsevier Inc
Collection year 2014
Language eng
Formatted abstract
Objective
To evaluate the effects of L-carnitine compared with placebo or control on morbidity and mortality in the setting of acute myocardial infarction.
Methods
A systematic review and meta-analysis of 13 controlled trials (N=3629) was conducted to determine the effects of L-carnitine vs placebo or control on mortality, ventricular arrhythmias (VAs), angina, heart failure, and reinfarction. These trials were identified via searches of the Ovid MEDLINE, PubMed, and Excerpta Medica (Embase) databases between May 1, 2012, and August 31, 2012.
Results
Compared with placebo or control, L-carnitine was associated with a significant 27% reduction in all-cause mortality (odds ratio, 0.73; 95% CI, 0.54-0.99; P=.05; risk ratio [RR], 0.78; 95% CI, 0.60-1.00; P=.05), a highly significant 65% reduction in VAs (RR, 0.35; 95% CI, 0.21-0.58; P<.0001), and a significant 40% reduction in the development of angina (RR, 0.60; 95% CI, 0.50-0.72; P<.00001), with no reduction in the development of heart failure (RR, 0.85; 95% CI, 0.67-1.09; P=.21) or myocardial reinfarction (RR, 0.78; 95% CI, 0.41-1.48; P=.45).
Conclusion
Compared with placebo or control, L-carnitine is associated with a 27% reduction in all-cause mortality, a 65% reduction in VAs, and a 40% reduction in anginal symptoms in patients experiencing an acute myocardial infarction. Further study with large randomized controlled trials of this inexpensive and safe therapy in the modern era is warranted.
Keyword Acute Myocardial-Infarction
Placebo-Controlled Trial
Tissue-Levels
Cedim Trial
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
School of Medicine Publications
 
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