A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL OF L-CARNITINE IN SUSPECTED ACUTE MYOCARDIAL-INFARCTION

In a randomised, double-blind placebo-controlled trial, the effects of the administration of oral L-carnitine (2 g/day) for ts days were com pared in the management of 51 (carnitine group) and 50 (placebo group) patients with suspected acute myocardial infarction. At study entry, the extent of cardiac disease, cardiac enzymes and lipid peroxides wer e comparable between the groups, although both groups showed an increa se in cardiac enzymes and lipid peroxides. At the end of the 28-day tr eatment period, the mean infarct size assessed by cardiac enzymes show ed a significant reduction in the carnitine group compared to placebo. Electrocardiographic assessment of infarct size revealed that the QRS -score was significantly less in the carnitine group compared to place bo (7.4 +/- 1.2 vs 10.7 +/- 2.0), white serum aspartate transaminase a nd lipid peroxides showed significant reduction in the carnitine group . Lactate dehydrogenase measured on the sixth or seventh day following infarction showed a smaller rise in the carnitine group compared to p lacebo. Angina pectoris (17.6 us 36.0%), New York Heart Association cl ass III and IV heart failure plus left ventricular enlargement (23.4 u s 36.0%) and total arrhythmias (13.7 vs 28.0%) were significantly less in the carnitine group compared to placebo. Total cardiac events incl uding cardiac deaths and non-fatal infarction were 15.6% in the carnit ine group vs 26.0% in the placebo group. It is possible that L-carniti ne supplementation in patients with suspected acute myocardial infarct ion may be protective against cardiac necrosis and complications durin g the first 28 days.