Date of Award
Selective Evidence-Based Medicine Review
Master of Science in Health Sciences - Physician Assistant
John Cavenagh, PhD, PA-C
OBJECTIVE: The objective of this selective EBM review is to determine whether or not L-carnitine decreases mortality rates post MI.
STUDY DESIGN: Review of three randomized controlled trials published in 1996, 2000, and 2012, all English language.
DATA SOURCES: Three double blind, randomized controlled clinical trials comparing mortality rates in patients post MI who were treated with L-carnitine or a placebo. All articles were found using PubMed and EBSCO.
OUTCOMES MEASURED: In the Singh et al. study the outcomes were total cardiac events that included death and nonfatal infarctions, cardiac enzymes activity, infarct size, and any complications that were measured by myocardial infarct size, cardiac enzyme levels of CK and CK-MB, radiology, and electrocardiographic. In the Colonna study, outcomes were: left ventricular dilation, end diastolic volume, systolic volume, incidence of death and heart failure at 6 months, and infarct size that were measured by an echocardiograph. In the Tarantini study, the outcomes measured were: combined occurrence of death and heart failure that were measured by deaths.
RESULTS: In the Singh et al. study the total cardiac events including nonfatal infarction and cardiac deaths were significantly fewer in the L-carnitine group compared to placebo in 28 days. In the Tarantini study, a reduction in mortality was seen in the L-carnitine arm of the study at 5 days. The Colonna study results show L-Carnitine does not seem to be effective in reducing mortality in patients after AMI.
CONCLUSIONS: The results of these RCTs suggest that L-carnitine isn’t much more effective in reducing mortality rates after AMIs than the placebo. There was some evidence to suggest that L-carnitine may be effective in reducing mortality short-term after an AMI but not long term. The studies reviewed demonstrated statistically significant decreases in mortality only in the time frame directly following an AMI.
Spearman, Jeremiah, "Is L-Carnitine Effective in Reducing Mortality After an Acute Myocardial Infarction?" (2014). PCOM Physician Assistant Studies Student Scholarship. 194.