Влияние l-карнитина на дисперсию интервала QT у пациентов с острым коронарным синдромом

Abstract

to evaluate the impact of L-carnitine on the dispersion of the interval QT (AQTc) in patients with acute coronary syndrome (ACS). In a prospective, randomized, double-blind, placebo-controlled study included 58 patients with ACS who have not had surgery (29 in group receiving L-carnitine, and 29 in the placebo group). L-carnitine was administered intravenously during the first 3 days to 2 g, 2 times a day, with 4 on the 15th day (or until discharge, if it occurred earlier)--for 1 g of 2 times per day. AQTc defined as the difference between the maximum and minimum duration of the QT interval in each of the 12 standard ECG leads surface--ECG (ΔQT = QTmax-QTmin) on the 1st, 2, 3, 5, 7 and 12-14th day. Compared groups did not differ in their baseline characteristics. Under the influence of L-carnitine reduction ΔQTc was more pronounced and significantly decreased since the 1st day of treatment. Thus, the group of patients treated with L-carnitine, ΔQTc decreased from 79.9 ± 19.9 to 60.4 ± 17.5 ms (p < 0.0001) and amounted to 12-14-th day of treatment 41.1 ± 7.6 ms (p < 0.0001) in the placebo group-respectively from 74.9 ± 23.2 to 68.3 ± 22.4 ms (p = 0.277) and 53.5 ± 15.0 ms (p = 0.0003). In the group of patients treated with L-carnitine, a decrease ΔQTc wore authentic character from the first day of the disease and unstable angina, and myocardial infarction. In the group of patients treated with placebo in unstable angina were not significant changes in the nature and in MI--reliability is marked only by the 7th day of the disease. Decrease in initial ΔQTc ΔQTc > 80 ms was more pronounced than in patients with ΔQTc < 80 ms. In the group of patients treated with L-carnitine, marked reduction ΔQTc less dependent on its initial value and was statistically significant in patients c great and not so great source ΔQTc. Thus, L-carnitine in patients with ACS reduces the severity of myocardial electrical instability.