PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

L-carnitine significantly improves patient outcomes following heart attack

Results of systematic review of 13 controlled studies reported in Mayo Clinic Proceedings

2013-04-12
(Press-News.org) Rochester, MN, April 12, 2013 – L-carnitine significantly improves cardiac health in patients after a heart attack, say a multicenter team of investigators in a study published today in Mayo Clinic Proceedings. Their findings, based on analysis of key controlled trials, associate L-carnitine with significant reduction in death from all causes and a highly significant reduction in ventricular arrhythmias and anginal attacks following a heart attack, compared with placebo or control.

Heart disease is the leading cause of death in the United States. Although many of the therapies developed in recent decades have markedly improved life expectancy, adverse cardiovascular events such as ventricular arrhythmias and angina attacks still occur frequently after an acute myocardial infarction (heart attack).

It is known that during ischemic events L-carnitine levels are depleted. Investigators sought to determine the effects of targeting cardiac metabolic pathways using L-carnitine to improve free fatty acid levels and glucose oxidation in these patients. By performing a systematic review and meta-analysis of the available studies published over several decades, they looked at the role of L-carnitine compared with placebo or control in patients experiencing an acute myocardial infarction.

L-carnitine is a trimethylamine which occurs in high amounts in red meat and is found in certain other foods, and is also widely available as an over-the-counter nutritional supplement which is claimed to improve energy, weight loss, and athletic performance. Its potential role in treating heart disease was first reported in the late 1970s.

A comprehensive literature search yielded 153 studies, 13, published from 1989-2007, were deemed eligible. All the trials were comparison trials of L-carnitine compared with placebo or control in the setting of acute myocardial infarction.

This systematic review of the 13 controlled trials in 3,629 patients, involving 250 deaths, 220 cases of new heart failure, and 38 recurrent heart attacks, found that L-carnitine was associated with:

Significant 27% reduction in all-cause mortality (number needed to treat 38) Highly significant 65% reduction in ventricular arrhythmias (number needed to treat 4) Significant 40% reduction in the development of angina (number needed to treat 3) Reduction in infarct size

There were numerically fewer myocardial reinfarctions and heart failure cases associated with L-carnitine, but this did not reach statistical significance.

First author James J. DiNicolantonio, PharmD, Wegmans Pharmacy, Ithaca, NY, observes, "Although therapies for acute coronary syndrome (ACS), including percutaneous coronary intervention, dual antiplatelet therapy, b-blockers (BBs), statins, angiotensin-converting enzyme inhibitors (ACEIs), omega-3 fatty acids, and cardiac rehabilitation, have markedly improved clinical outcomes, adverse cardiovascular (CV) events still occur too frequently after ACS. One promising therapy for improving cardiac health involves using L-carnitine to improve free fatty acid levels and glucose oxidation."

"The potential mechanisms responsible for the observed beneficial impact of L-carnitine in acute myocardial infarction are likely multifactorial and may, in part, be conferred through the ability of L-carnitine to improve mitochondrial energy metabolism in the heart by facilitating the transport of long-chain fatty acids from the cytosol to the mitochondrial matrix, where b-oxidation occurs, removing toxic fatty acid intermediates, reducing ischemia induced by long-chain fatty acid concentrations, and replenishing depleted carnitine concentrations seen in ischemic, infarcted, and failing myocardium," says DiNicolantonio.

L-carnitine is proven to be safe and is readily available over the counter. The investigators agree that the overall results of this meta-analysis support the potential use of L-carnitine in acute myocardial infarction and possibly in secondary coronary prevention and treatment, including angina. They advocate for a larger randomized, multicenter trial to be performed to confirm these results in the modern era of routine revascularization and other intensive medical therapies following acute myocardial infarction. But, says DiNicolantonio, "L-carnitine therapy can already be considered in selected patients with high-risk or persistent angina after acute myocardial infarction who cannot tolerate treatment with ACE inhibitors or beta blockers, considering its low cost and excellent safety profile."

These findings may seem to contradict those reported in a study published earlier this month in Nature Medicine by Robert A. Koeth and others (Koeth, R. A. et al. Nature Med. http://dx.doi.org/10.1038/nm.3145), which demonstrated that metabolism by intestinal microbiota of dietary L-carnitine produced trimethylamine N-oxide (TMAO) and accelerated atherosclerosis in mice. They also noted that omnivorous human subjects produced more TMAO than did vegans or vegetarians following ingestion of L-carnitine, and suggested a possible direct link between L-carnitine, gut bacteria, TMAO, and atherosclerosis and risk of ischemic heart disease.

"The Nature Medicine paper is of interest," agrees senior investigator Carl J. Lavie, M.D.,FACC,FACP,FCCP, Medical Director of the Cardiac Rehabilitation and Prevention Center at the John Ochsner Heart and Vascular Institute at the University of Queensland School of Medicine in New Orleans, "but the main study reported there was in animals, and unlike our study, lacks hard outcomes." He also notes that "there are various forms of 'carnitine' and our relatively large meta-analysis specifically tested L-carnitine on hard outcomes in humans who had already experienced acute myocardial infarction."

INFORMATION:

END



ELSE PRESS RELEASES FROM THIS DATE:

Teenage smoking behavior influenced by friends' and parents' smoking habits

2013-04-12
LOS ANGELES – The company you keep in junior high school may have more influence on your smoking behavior than your high school friends, according to newly published research from the University of Southern California (USC). The study, which appears in the April 12 issue of the Journal of Adolescent Health, identifies how friends' and parental influence on cigarette smoking changes from junior high to high school. The research indicates that intervention targets to counteract friends' influence may have more of an effect in junior high than in high school, and that ...

CO2 removal can lower costs of climate protection

2013-04-12
According to the analysis, carbon dioxide removal could be used under certain requirements to alleviate the most costly components of mitigation, but it would not replace the bulk of actual emissions reductions. "Carbon dioxide removal from the atmosphere allows to separate emissions control from the time and location of the actual emissions. This flexibility can be important for climate protection," says lead-author Elmar Kriegler. "You don't have to prevent emissions in every factory or truck, but could for instance plant grasses that suck CO2 out of the air to grow ...

Disappearing nannies force parents to accept their duties

2013-04-12
Large helpers (nannies) in a cichlid fish allow the dominant male and female to reduce their personal contribution to their offspring and territory, according to new research published today in Functional Ecology. By removing the large helper for 30 days – which corresponds to one breeding cycle in this species – a team from the University of Bristol and the University of Bern (Switzerland) studied the investment strategies of the dominant pair and the survival of their brood, while checking for immigration of new helpers. Dr Rick Bruintjes, NERC Science & Business ...

Study proposes alternative way to explain life's complexity

2013-04-12
Durham, NC —Evolution skeptics argue that some biological structures, like the brain or the eye, are simply too complex for natural selection to explain. Biologists have proposed various ways that so-called 'irreducibly complex' structures could emerge incrementally over time, bit by bit. But a new study proposes an alternative route. Instead of starting from simpler precursors and becoming more intricate, say authors Dan McShea and Wim Hordijk, some structures could have evolved from complex beginnings that gradually grew simpler — an idea they dub "complexity by subtraction." ...

Clues to heart disease in unexpected places, Temple researchers discover

2013-04-12
(Philadelphia, PA) – A major factor in the advance of heart disease is the death of heart tissue, a process that a team of scientists at Temple University School of Medicine's (TUSM) Center for Translational Medicine think could be prevented with new medicines. Now, the researchers are one step closer to achieving that goal, thanks to their discovery of a key molecule in an unexpected place in heart cells – mitochondria, tiny energy factories that house the controls capable of setting off cells' self-destruct sequence. The study is the first to identify the molecule, ...

IFR scientists use the force to decode secrets of our gut

2013-04-12
A new technique based on atomic force microscopy was developed at the Institute of Food Research to help 'read' information encoded in the gut lining. The lining of our gut is an important barrier between the outside world and our bodies. Laid out, the gut lining would cover the area of a football pitch. It must let nutrients from our foods through, but prevent invasion by disease-causing bacteria, at the same time hosting the trillions of beneficial bacteria needed for proper digestion and immune function. At the forefront of the defensive system is a layer of mucus ...

Gene may help identify risk of Alzheimer's in African Americans, Mayo Clinic says

2013-04-12
JACKSONVILLE, Fla. — Researchers at Mayo Clinic in Florida participated in a nationwide study that found minor differences between genes that contribute to late-onset Alzheimer's disease in African-Americans and in Caucasians. The study, published April 10 in The Journal of the American Medical Association, was the first to look at the genetics of a large number of African-Americans diagnosed with this common form of Alzheimer's disease (1,968 patients) compared to 3,928 normal elderly African-American control participants. The Alzheimer's Disease Genetics Consortium ...

Secrets of bacterial slime revealed

2013-04-12
Newcastle University scientists have revealed the mechanism that causes a slime to form, making bacteria hard to shift and resistant to antibiotics. When under threat, some bacteria can shield themselves in a slimy protective layer, known as a biofilm. It is made up of communities of bacteria held together to protect themselves from attack. Biofilms cause dental plaque and sinusitis; in healthcare, biofilms can lead to life threatening and difficult to treat infections, particularly on medical implants such as catheters, heart valves, artificial hips and even breast ...

Reactivating memories during sleep

2013-04-12
EVANSTON, Ill. --- Why do some memories last a lifetime while others disappear quickly? A new study suggests that memories rehearsed, during either sleep or waking, can have an impact on memory consolidation and on what is remembered later. The new Northwestern University study shows that when the information that makes up a memory has a high value (associated with, for example, making more money), the memory is more likely to be rehearsed and consolidated during sleep and, thus, be remembered later. Also, through the use of a direct manipulation of sleep, the research ...

Fires in Central America

2013-04-12
On April 11, 2013, the Moderate Resolution Imaging Spectroradiometer (MODIS) aboard NASA's Aqua satellite passed over Mexico and Central America, and acquired this true-color image of dozens of fires burning across the region. Fires dot the landscapes of Mexico, Guatemala, El Salvador, and Honduras in this image. Each red mark that appears is an area where the thermal detectors on the MODIS instrument recognized temperatures higher than the background which means that most likely those dots are fires. As these dots appear in satellite images during April, the dry season ...

LAST 30 PRESS RELEASES:

SwRI-built instruments to monitor, provide advanced warning of space weather events

Breakthrough advances sodium-based battery design

New targeted radiation therapy shows near-complete response in rare sarcoma patients

Does physical frailty contribute to dementia?

Soccer headers and brain health: Study finds changes within folds of the brain

Decoding plants’ language of light

UNC Greensboro study finds ticks carrying Lyme disease moving into western NC

New implant restores blood pressure balance after spinal cord injury

New York City's medical specialist advantage may be an illusion, new NYU Tandon research shows

Could a local anesthetic that doesn’t impair motor function be within reach?

1 in 8 Italian cetacean strandings show evidence of fishery interactions, with bottlenose and striped dolphins most commonly affected, according to analysis across four decades of data and more than 5

In the wild, chimpanzees likely ingest the equivalent of several alcoholic drinks every day

Warming of 2°C intensifies Arctic carbon sink but weakens Alpine sink, study finds

Bronze and Iron Age cultures in the Middle East were committed to wine production

Indian adolescents are mostly starting their periods at an earlier age than 25 years ago

Temporary medical centers in Gaza known as "Medical Points" (MPs) treat an average of 117 people daily with only about 7 staff per MP

Rates of alcohol-induced deaths among the general population nearly doubled from 1999 to 2024

PLOS One study: In adolescent lab animals exposed to cocaine, High-Intensity Interval Training boosts aversion to the drug

Scientists identify four ways our bodies respond to COVID-19 vaccines

Stronger together: A new fusion protein boosts cancer immunotherapy

Hidden brain waves as triggers for post-seizure wandering

Music training can help the brain focus

Researcher develop the first hydride ion prototype battery

MIT researchers find a more precise way to edit the genome

‘Teen’ pachycephalosaur butts into fossil record

Study finds cocoa extract supplement reduced key marker of inflammation and aging

Obesity treatment with bariatric surgery vs GLP-1 receptor agonists

Nicotinamide for skin cancer chemoprevention

Novel way to ‘rev up’ brown fat burns calories, limits obesity in mice

USC Stem Cell-led team makes major advance toward building a synthetic kidney

[Press-News.org] L-carnitine significantly improves patient outcomes following heart attack
Results of systematic review of 13 controlled studies reported in Mayo Clinic Proceedings