[L-carnitine for the treatment of acute myocardial infarct]

The treatment with L-carnitine in acute myocardial infarction was tested in 146 patients admitted in a coronary care unit. The administration of L-carnitine was based upon the drug availability and did not occur at random. Altogether 49 patients received the drug and 97 served as controls. By comparing the clinical characteristics at hospital admission a worse prognosis could be expected in those who did not receive the drug. Within 28 days from admission no deaths were observed in the treated group whereas 18 deaths (18.6 percent) were recorded among the controls. The prediction of fatal events was estimated by multiple logistic function taking the 28-days mortality as end point (either including or excluding the 72 hours early deaths) and using 2 different sets of factors as possible predictors, including the use of the drug. In particular there were 18 factors usually claimed as determinants of short term prognosis and 9 factors which were shown statistically different between the 2 groups. In all the 4 solutions the coefficient of L-carnitine was negative and in 3 of them also statistically significant, suggesting the protective role of the drug against early fatalities. Only the coefficient of the clinical impression of severity showed a greater statistical significance. The reported observations can be defined as the results of a pilot study which justify a more systematic study of the drug in the acute phase of myocardial infarction.