June 2, 1998Circulation
Long-term l -Arginine Supplementation Improves Small-Vessel Coronary Endothelial Function in Humans
Key result
Oral L-arginine improves acetylcholine-mediated coronary blood flow reserve to ~149% vs. placebo.
- P<0.05
- n=26
Why the study?
Coronary endothelial dysfunction involves imbalance of vasodilating and vasoconstricting factors and coronary vasoconstriction to acetylcholine, and the effect of long-term L-arginine supplementation on this dysfunction was unknown.
Does oral L-arginine improve endothelium-dependent coronary blood flow reserve in patients with nonobstructive coronary artery disease?
Comparison
Oral L-arginine 3 g TID vs placebo for 6 months
Design
Double-blind randomized study
Follow-up
6 months
Authors
Discussion
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Implication
Supports L-arginine for endothelial dysfunction in nonobstructive CAD; extends prior data to long-term randomized oral use.
Study Design
Type
RCT (n=26)
Blinding
Double-blind
Randomization
randomized
Structured PICO
Does oral L-arginine improve endothelium-dependent coronary blood flow reserve in patients with nonobstructive coronary artery disease?
P
Population
26 patients with nonobstructive coronary artery disease (without significant coronary artery disease on coronary angiography and intravascular ultrasound)
I
Intervention
Oral L-arginine 3 g TID for 6 months
C
Comparator
Oral placebo 3 g TID for 6 months
O
Outcome
Endothelium-dependent coronary blood flow reserve to acetylcholine (10(-6) to 10(-4) mol/L) at 6 monthssurrogate
Main Result
Absolute Event Rate: 149% vs 6%
p-value: p=< 0.05
Long-term oral L-arginine supplementation for 6 months improves coronary small-vessel endothelial function and symptoms in patients with nonobstructive coronary artery disease.
Cite This Study
Lerman et al. (1998) conducted an RCT in nonobstructive coronary artery disease (n=26). oral L-arginine vs. placebo was evaluated on Endothelium-dependent coronary blood flow reserve to acetylcholine (p=< 0.05). Long-term oral L-arginine supplementation significantly increased coronary blood flow in response to acetylcholine compared with placebo (149% vs 6%, P<0.05).