Key result
Oral L-carnitine maintenance doses of greater or less than 3 g per day provided no significant marginal benefit for all-cause mortality or cardiovascular morbidities in patients with acute myocardial infarction.
Why the study?
Does oral L-carnitine maintenance therapy at various dosages reduce all-cause mortality and cardiovascular morbidities in adults with acute myocardial infarction?
Meta-Analysis (n=3,108)
Does oral L-carnitine maintenance therapy at various dosages reduce all-cause mortality and cardiovascular morbidities in adults with acute myocardial infarction?
There appears to be no significant marginal benefit in terms of all-cause mortality or cardiovascular morbidities for oral L-carnitine maintenance doses greater or less than 3 g per day in the setting of acute myocardial infarction.
Answers are grounded in this paper and cite their sources.
L-carnitine maintenance adds no mortality or morbidity benefit post-AMI regardless of dose; confirms null effect and advises against routine use.
BACKGROUND: L-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. METHODS: After 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. RESULTS: The 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). CONCLUSIONS: There 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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Shang et al. (2014) conducted a meta-analysis in Acute myocardial infarction (n=3,108). L-carnitine vs. Placebo or control was evaluated on All-cause mortality (RR 0.77, 95% CI 0.57-1.03, p=0.08). Oral L-carnitine maintenance doses of greater or less than 3 g per day provided no significant marginal benefit for all-cause mortality or cardiovascular morbidities in patients with acute myocardial infarction.
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