April 13, 2013
L-Carnitine Could Improve Cardiac Health Following Heart Attack
redOrbit Staff & Wire Reports — Your Universe Online
While foods like steaks and hamburgers are often negatively linked to cardiovascular health, new research published in Friday´s edition of Mayo Clinic Proceedings suggests a compound commonly found in red meat could actually improve cardiac health in patients following a heart attack.The authors of that paper conducted a systematic review of 13 different controlled studies and linked the compound L-carnitine with a “significant reduction” in the risk of death from all causes following a heart attack. Furthermore, the substance was linked with a “highly significant reduction” of death resulting from ventricular arrhythmias and anginal attacks following a cardiac event, when compared to control groups or placebos.
During ischemic events, or events resulting from a restriction in blood supply to tissues, a person´s L-carnitine levels are depleted. The authors of the Mayo Clinic Proceedings set out to discover what impact would result from targeting using the compound to target cardiac metabolic pathways and improve free fatty acid levels and glucose oxidation in those patients. They performed both a systematic review and a meta-analysis of several decades worth of studies, investigating the role of L-carnitine compared to placebo or control in heart attack patients.
Thirteen controlled trials involving more than 3,600 patients -- which involved 250 fatalities, 220 new cases of heart failure, and 38 recurrent heart attacks -- were studied. In those studies, L-carnitine was associated with a 27 percent reduction in all-cause mortality, a 65 percent reduction in ventricular arrhythmias, a 40 percent reduction in the development of angina, and an overall reduction infarct size, the researchers discovered.
“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,” first author James J. DiNicolantonio of Wegmans Pharmacy in Ithaca, New York, said in a statement. “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,” he added.
DiNicolantonio and his colleagues said that the findings of their meta-analysis support the potential use of L-carnitine in acute myocardial infarction, as well as potentially for secondary coronary prevention and treatment of heart conditions such as angina. They are pushing for a larger, randomized, multicenter trial in order to confirm the overall results of their research.
In addition to being found in high levels in red meat, L-carnitine is also found in energy drinks and is available as an over-the-counter nutritional supplement, the researchers explained. Its potential role in treating heart disease dates back to the late 1970s; however, research published earlier this month revealed that the compound presents a previously unknown health risk.
According to researchers from the Cleveland Clinic in Ohio, L-carnitine can be metabolized by bacteria and changed into trimethylamine-N-oxide (TMAO) — a substance that has previously been linked to atherosclerosis (clogging or hardening of the arteries) and ischemic heart disease.