Key result
Oral L-arginine shows no mortality benefit over placebo in acute MI.
Why the study?
Does oral L-arginine supplementation reduce mortality in patients with acute myocardial infarction?
Meta-Analysis (n=927)
Placebo-controlled
Randomized
Does oral L-arginine supplementation reduce mortality in patients with acute myocardial infarction?
Relative Risk: 0.93 (95% CI 0.74–1.17)
Absolute Event Rate: 22.9% vs 24.4%
p-value: p=0.54
Oral L-arginine supplementation does not improve clinical outcomes or reduce mortality in patients with acute myocardial infarction.
L-arginine should not be used in acute MI; meta-analysis confirms no mortality benefit.
OBJECTIVE: The objective was to analyze completed trials assessing the effect of oral L-arginine supplementation on clinical outcomes of patients with acute myocardial infarction (AMI). BACKGROUND: Prior trials suggest that oral L-arginine administration improves endothelial function in patients with stable coronary artery disease (CAD). However, it is still unclear whether oral supplementation of L-arginine has any effect on clinical outcomes in patients with unstable CAD, such as AMI. METHODS: We systematically searched PubMed, Cochrane Library, Embase, reviews, and reference lists of relevant articles. The search strategy paired the term "arginine" with the following: "coronary heart disease," "myocardial infarction," "cardiovascular disease," "ischemia," and "trial." We conducted a meta-analysis of randomized, placebo-controlled L-arginine supplementation trials that evaluated clinical outcomes in AMI patients. Two reviewers independently assessed the trials. Differences were resolved by consensus. RESULTS: Only 2 trials (927 participants) were included. None of the 2 studies showed a significant difference in event rate between the L-arginine and placebo groups. In an overall pooled estimate, there was a 7% reduction in mortality in the L-arginine treatment group (105/459, 22.9%) compared with the control group (111/455, 24.4%), which did not reach statistical significance (risk ratio [RR]: 0.93, 95% confidence interval [CI]: 0.74-1.17; P = 0.54). CONCLUSION: Oral L-arginine supplementation has no effect on the clinical outcomes of patients with AMI.
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Sun et al. (2009) conducted a meta-analysis in Acute myocardial infarction (AMI) (n=927). Oral L-arginine supplementation vs. Placebo was evaluated on Mortality (RR 0.93, 95% CI 0.74-1.17, p=0.54). Oral L-arginine supplementation did not significantly reduce mortality compared with placebo in patients with acute myocardial infarction (22.9% vs 24.4%; RR 0.93; 95% CI 0.74-1.17; P=0.54).
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