Iyer R, Gupta A, Khan A, Hiremath S, Lokhandwala Y
Department of Cardiology, Seth G.S. Medical College and K.E.M. Hospital, Parel, Mumbai, India.
J Postgrad Med. 1999 Apr-Jun;45(2):38-41.
A double blind randomized placebo controlled clinical trial was carried out to assess the efficacy and safety of L-carnitine in patients suffering from acute anterior wall myocardial infarction with respect to left ventricular function. Sixty patients (34 men, 26 women, mean age 56+11 yr.) with acute anterior wall myocardial infarction were randomized to placebo and L-carnitine. All the patients were given intravenous L-carnitine / placebo in the dose of 6gm/day for the first seven days followed by oral L-carnitine / placebo 3 gm/day in three divided doses for a period of three months. Echocardiography was performed for regional wall motion abnormality, left ventricular end systolic volume (ESV), end diastolic volume (EDV) and ejection fraction (EF) on admission, after seven days and after three months of the infarction. Forty-four patients completed the study. There were three deaths, two in the placebo and one in the L-carnitine group (p>0.05). Thirteen patients were lost to follow up. Echo parameters in both groups were comparable (p>0.05). The duration of chest pain prior to initiation of the I.V. L-carnitine was 7.5 + 5.2 hrs in the L-carnitine group and 7 + 4 hrs in the placebo group (p>0.05). There was no statistical difference in the EF, ESV and EDV on admission, at discharge and after three months in the L-carnitine and the placebo groups (p>0.05). No significant adverse effects were noted. L-carnitine, though a safe drug, does not affect the left ventricular function in patients with myocardial infarction.
开展了一项双盲随机安慰剂对照临床试验，以评估左旋肉碱对急性前壁心肌梗死患者左心室功能的疗效和安全性。60例急性前壁心肌梗死患者（34例男性，26例女性，平均年龄56±11岁）被随机分为安慰剂组和左旋肉碱组。所有患者在开始的7天内静脉给予剂量为6克/天的左旋肉碱/安慰剂，随后3个月口服左旋肉碱/安慰剂，3克/天，分三次服用。在入院时、心肌梗死后7天和3个月时进行超声心动图检查，以评估节段性室壁运动异常、左心室收缩末期容积（ESV）、舒张末期容积（EDV）和射血分数（EF）。44例患者完成了研究。有3例死亡，安慰剂组2例，左旋肉碱组1例（p>0.05）。13例患者失访。两组的超声心动图参数具有可比性（p>0.05）。左旋肉碱组静脉注射左旋肉碱前胸痛持续时间为7.5±5.2小时，安慰剂组为7±4小时（p>0.05）。左旋肉碱组和安慰剂组在入院时、出院时和3个月后的EF、ESV和EDV方面无统计学差异（p>0.05）。未观察到明显的不良反应。左旋肉碱虽然是一种安全的药物，但对心肌梗死患者的左心室功能没有影响。
