Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Acetyl l-carnitine (ALC) has some scientific evidence supporting its use as an adjunctive treatment for angina, though the evidence is not robust and its use is not considered mainstream. ALC is a derivative of l-carnitine, a compound involved in mitochondrial energy metabolism and fatty acid transport. The rationale for using ALC in angina is that it may enhance myocardial energy metabolism, reduce ischemia, and improve exercise tolerance, potentially alleviating symptoms of angina pectoris.

Several small clinical studies, mostly from Italy and other parts of Europe, have investigated the effects of l-carnitine and acetyl l-carnitine supplementation in patients with stable angina. Some randomized controlled trials (RCTs) have shown modest improvements in exercise tolerance, reduction in the frequency of angina attacks, and decreased need for nitroglycerin in patients receiving l-carnitine or its derivatives as adjuncts to standard therapy. A 2013 meta-analysis (Am J Clin Nutr 2013;97(2):268-76) suggested a potential benefit of l-carnitine in reducing symptoms and mortality after acute myocardial infarction, though the data for stable angina are less robust and often involve small sample sizes.

ALC is generally well-tolerated, but the evidence supporting its use for angina is limited, with methodological concerns in many studies. Major clinical guidelines do not recommend ALC as part of standard angina management. Thus, while there is some scientific rationale and preliminary evidence, it is not strong enough to warrant routine clinical use, and ALC should not replace established treatments for angina.

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