2015


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2015/№2

Effect of L-carnitine on heart rate and QTс in patients with acute coronary syndrome

Glezer M. G., Kiseleva A. E., Astashkin E. I.
State Budgetary Educational Institution, “I. M. Sechenov First Moscow State Medical University” at the RF Ministry of Health Care, Trubetskaya 8, Bld.2, Moscow 119991

Keywords: L-carnitine, corrected QT, ACS, heart rate

DOI: 10.18087/rhj.2015.2.2072

Aim. To evaluate the capability of L-carnitine for QT correction in patients with acute coronary syndrome (ACS). Materials and methods. This prospective, double-blind, randomized, placebo-controlled study included 58 patients with ACS who have not undergone surgical interventions (29 patients in the L-carnitine treatment group and 29 patients in the placebo group). L-carnitine 2 g i.v., was administered twice daily during the first 3 days and 2 g once daily – from day 4 through day 15 (or until discharge from the hospital if occurred earlier). The QT interval was measured on days 1, 2, 3, 5, 7, and 12–14 of the disease in standard lead II for at least three successive cycles; mean values were calculated. The values were corrected for the heart rate (HR) according to the Bazett formula (QTc). Results. The compared groups did not differ in their baseline characteristics. Reduced HR and QTc values were observed in both groups. However, in the placebo group, the QTc decrease was not significant (from 439.1±36.9 msec to 422.9±27.7 msec at days 12–14 of ACS). In the L-carnitine treatment group, the QTc decrease from day 1 to days 12–14 of disease was significant (from 457.5±39.5 msec to 413.2±30.5 msec; p<0.00001). In the L-carnitine group, the decrease was significantly greater at all observation points, and at days 12–14 it reached 9.3±7.3 % vs. –2.0±8.2 % in the placebo group (р=0.002). The decrease in QTc was greater for patients with the baseline QTc duration above 440 msec. In the L-carnitine group, significant decreases were observed from the first day of disease whereas in the placebo group – only by day 7 of disease. When baseline QTc was shorter than 440 msec, significant decreases were observed in the L-carnitine group by day 7 of disease whereas changes were absent in the placebo group. In patients with MI, significant QTc changes in response to the L-carnitine treatment were observed from the first day of disease, and the magnitude of the QTc decrease was significantly different from QTc changes in the placebo group. The QTc decrease was not significant in patients with unstable angina. Conclusion. L-carnitine restricted changes in the corrected QT interval, the marker for high risk of unfavorable events, in ACS patients.
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Glezer M. G., Kiseleva A. E., Astashkin E. I. Effect of L-carnitine on heart rate and QTс in patients with acute coronary syndrome. Russian Heart Journal. 2015;14 (2):78–84

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