L-carnitine in cardiology: reality and perspectives

Abstract

Carnitine is a substance close to vitamins B, which participates in the mitochondrial energy synthesis. L-carnitine controls the rate of the long-chain fatty acid oxidation and acts as a specific co-factor facilitating their transport via the internal mitochondrial membrane. It also participates in the elimination of long-chain fatty acid excess from mitochondria and cytoplasm. These effects prevent cytotoxicity. This review presents the results of the studies which comply with the standards of evidence-based medicine. It has been shown that in patients with acute myocardial infarction (AMI), L-carnitine therapy was associated with a reduction in myocardial necrosis and an improved clinical course of AMI (end-point incidence in the main and control groups was 15,6% and 26%, respectively). In the first 5 days of L-carnitine therapy, there was a significant reduction in mortality in the main group of AMI patients. In patients with stable angina, L-carnitine reduces the risk of all-cause mortality, repeat AMI, and ventricular arrhythmias. In patients with intermittent claudication, L-carnitine significantly increases the pain-free walking distance. This medication is well tolerated, with no registered major adverse effects.

Keywords

• l-carnitine
• acute myocardial infarction
• intermittent claudication