Synopsis

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

Phosphocreatine (also known as creatine phosphate) has been investigated for its potential role in supporting or treating heart weakness, particularly in the context of heart failure and during cardiac surgery. The rationale is based on its critical function in cardiac muscle energy metabolism: phosphocreatine acts as a rapid reserve of high-energy phosphates to regenerate ATP, which is essential for myocardial contraction. In heart failure, myocardial energy stores—including phosphocreatine—are often depleted, leading to impaired contractility and function.

Several clinical studies, mainly from the 1970s to the early 2000s, explored intravenous phosphocreatine administration in acute cardiac settings (such as myocardial infarction, cardiac surgery, and heart failure). Some small randomized and non-randomized studies suggested that phosphocreatine might improve cardiac function, reduce arrhythmias, and enhance recovery after ischemic events. However, these studies were generally small, of variable quality, and produced inconsistent results. More recent meta-analyses and reviews (e.g., a 2013 meta-analysis in Cardiology) concluded that while there are indications of benefit, the overall quality and quantity of evidence do not support routine clinical use due to insufficient robust, large-scale trials.

Phosphocreatine is not widely used or recommended in current cardiology guidelines, and its use remains experimental. Thus, while there is a scientific basis and some clinical investigation, the evidence supporting phosphocreatine for heart weakness is weak to moderate at best.

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