The Effect of L-Carnitine on Left Ventricular Function in Patients with Acute Myocardial Infarction Treated with Streptokinase

We examined the effect of l-carnitine (LC) on left ventricular (LV) function in patients (pts) with a first acute anterior myocardial infarction (AMI) treated with trombolytic agents. Twelve pts who were treated with streptokinase (SK) within 6 hours of MI were given L 9 g/day IV for 5 days followed by 3 g/day orally for 3 months (group A). Eighteen pts treated with SK received no LC (group B). Wall motion indices (WMI) and LV diastolic volume indices (DVI) were echocardiographically determined at 5th and 10th days, and 1st and 3rd months. LV ejection fraction (EF) was measured by radionuclide ventriculography at respective times. No significant difference was found between the groups with age, gender, risk factors, the extent of coronary artery disease and the patency rate of infarct-related artery. In group A; WMI was measured 3.08±0.29, 3.41±0.4, 3.75±0.51 and 4.18±0.47 at 5th and 10th days, and 1st and 3rd months respectively. In group B; it was 2.91 was 2.91±0.31, 3.26±0.43, 3.41±0.42 and 3.75±0.51 respectively. There was a significant improvement with WMI at 3 months in both groups (36% increase in group A and 31% in group B), but the difference between the groups at respective times was not significant. In group. A; DVI was 55.5±11.1, 55±10.8, 56.5±14.4 and 54.9±11 ml/m2 and in group B; 58.5±9.8, 58.7±10.1, 59.1±11.4 and 60.7±14.7 ml/mg at 5th and 10th days, and 1st and 3rd months. No difference was observed both in the follow-up period in the groups and between the groups in respective times. EF values in group a were; 39.8±7.97% (5th day), 44.9±6.91 % (10th) day), 45.8±5.45% (1st month) and 52±4.76% (3rd month). In group B, respective EF values were; 37.8±8.11%, 42.5±79%, 45±9.23% and 46.8±9.36% EF at 3 months increased by 31 % in group A and 24% in group B. The difference at each time points in each groups was significant, but no significant difference was found between the groups. In conclusion, LC treatment in pts with MI and treated with SK resulted in no significant improvement in LV function.