Original articleL-Carnitine in the Secondary Prevention of Cardiovascular Disease: Systematic Review and Meta-analysis
Section snippets
Methods
We performed a systematic review of the available literature according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines for the conduct of systematic reviews of intervention studies.10
Identification and Selection of Studies
The literature search yielded 153 titles, of which 18 were reviewed in full text on the basis of the inclusion criteria. Of these, 13 studies were deemed eligible for inclusion (Figure 1).4, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 Supplemental Tables 1 and 2 (available online at http://www.mayoclinicproceedings.org) summarize the characteristics of the included studies and the risk of bias in the included trials.4, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25 Supplemental Table 3
Discussion
This systematic review of 13 controlled trials in 3629 patients involving 250 deaths, 220 cases of new HF, and 38 recurrent myocardial infarctions found that the use of L-carnitine was associated with a significant reduction in all-cause mortality and a highly significant reduction in VAs and anginal attacks.
The potential mechanisms responsible for the observed beneficial impact of L-carnitine in AMI are likely multifactorial and may, in part, be conferred through the ability of L-carnitine to
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 AMI. Further study with large randomized controlled trials of this inexpensive and safe therapy in the modern era is warranted.
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