Evidence supporting the use of: L-carnitine
For the health condition: Angina

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

L-carnitine is an amino acid derivative naturally involved in energy metabolism, particularly in the transport of fatty acids into mitochondria for beta-oxidation. Its use in angina is primarily supported by scientific investigation, though the strength of evidence is moderate rather than robust. Several randomized controlled trials and meta-analyses have explored the effect of L-carnitine supplementation on stable angina and ischemic heart disease. These studies generally indicate that L-carnitine may help reduce symptoms such as chest pain and improve exercise tolerance by enhancing myocardial energy metabolism and possibly reducing ischemic injury. A notable meta-analysis published in the journal Circulation (1999) found that L-carnitine supplementation reduced all-cause mortality, ventricular arrhythmias, and new-onset angina in patients after acute myocardial infarction. Subsequent studies have shown modest improvements in exercise capacity and a reduction in the frequency of angina attacks in patients with chronic stable angina. The proposed mechanism involves improved oxygen utilization and decreased accumulation of toxic metabolites in cardiac tissue during ischemia. However, the overall evidence remains moderate (rated 3/5), as some studies show minimal or no benefit, and the sample sizes are often small. L-carnitine is generally considered safe and is used as an adjunct to conventional therapy in some regions. Clinical guidelines do not universally recommend it, but it may be considered when standard treatments are insufficient or not tolerated.

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