L-carnitine supplementation to prevent postoperative complications after cardiac surgery: A systematic review and meta-analysis of randomised clinical trials
Background and Aims: Cardiac surgeries often lead to postoperative complications, which affect recovery and increase morbidity and mortality. This systematic review aims to assess L-carnitine’s effect on preventing postoperative complications across various cardiac surgeries, addressing gaps in curr...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-06-01
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | https://journals.lww.com/10.4103/ija.ija_1325_24 |
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| author | Laila Shalabi Ahmed Ibrahim Mohamed Adel Elsawy Sofian Zreigh Muhiddin Dervis Mohamed N. Elshabrawi Sohaila Mourad Mohamed A. Arafa Mohamed Abuelazm |
| author_facet | Laila Shalabi Ahmed Ibrahim Mohamed Adel Elsawy Sofian Zreigh Muhiddin Dervis Mohamed N. Elshabrawi Sohaila Mourad Mohamed A. Arafa Mohamed Abuelazm |
| author_sort | Laila Shalabi |
| collection | DOAJ |
| description | Background and Aims:
Cardiac surgeries often lead to postoperative complications, which affect recovery and increase morbidity and mortality. This systematic review aims to assess L-carnitine’s effect on preventing postoperative complications across various cardiac surgeries, addressing gaps in current literature on its potential therapeutic benefits.
Methods:
We systematically searched Web of Science, Cochrane, Embase, PubMed, and Scopus databases until March 2025. Statistical analysis was performed using R version 4.3.2. Effect sizes were measured with relative risks (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, while heterogeneity was evaluated using the I² statistic.
Results:
Thirteen randomised controlled trials(RCTs) with 786 patients were included. L-carnitine significantly increased the cardiac index (CI) (MD: 0.14; 95% CI: 0.07, 0.20; P < 0.01) and left ventricular stroke work index (LVSWI) (MD: 0.42; 95% CI: 0.06, 0.78; P = 0.02). In addition, L-carnitine significantly improved the left ventricular ejection fraction (LVEF) (MD: 7.88; 95% CI: 6.67, 9.09; P < 0.01), with a significant reduction in postoperative atrial fibrillation (POAF) (RR: 0.53; 95% CI: 0.30, 0.95; P = 0.03). In contrast, there was no significant reduction in in-hospital mortality (RR: 0.51; 95% CI: 0.10, 2.63; P = 1.00) and stroke incidence (RR: 0.85; 95% CI: 0.12, 5.76; P = 0.82).
Conclusion:
Preoperative administration of L-carnitine demonstrates meaningful short-term benefits in enhancing CI, LVSWI, and LVEF while reducing the incidence of POAF following cardiac surgery. These findings suggest a potential role for L-carnitine supplementation in optimising perioperative cardiac care, enhancing recovery, and reducing complications following cardiac surgery. However, the existing studies are limited in scope, making it challenging to draw robust conclusions. |
| format | Article |
| id | doaj-art-2783d9b2700549db831aee90d6bc7db4 |
| institution | OA Journals |
| issn | 0019-5049 0976-2817 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj-art-2783d9b2700549db831aee90d6bc7db42025-08-20T02:32:29ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172025-06-0169654756010.4103/ija.ija_1325_24L-carnitine supplementation to prevent postoperative complications after cardiac surgery: A systematic review and meta-analysis of randomised clinical trialsLaila ShalabiAhmed IbrahimMohamed Adel ElsawySofian ZreighMuhiddin DervisMohamed N. ElshabrawiSohaila MouradMohamed A. ArafaMohamed AbuelazmBackground and Aims: Cardiac surgeries often lead to postoperative complications, which affect recovery and increase morbidity and mortality. This systematic review aims to assess L-carnitine’s effect on preventing postoperative complications across various cardiac surgeries, addressing gaps in current literature on its potential therapeutic benefits. Methods: We systematically searched Web of Science, Cochrane, Embase, PubMed, and Scopus databases until March 2025. Statistical analysis was performed using R version 4.3.2. Effect sizes were measured with relative risks (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes, while heterogeneity was evaluated using the I² statistic. Results: Thirteen randomised controlled trials(RCTs) with 786 patients were included. L-carnitine significantly increased the cardiac index (CI) (MD: 0.14; 95% CI: 0.07, 0.20; P < 0.01) and left ventricular stroke work index (LVSWI) (MD: 0.42; 95% CI: 0.06, 0.78; P = 0.02). In addition, L-carnitine significantly improved the left ventricular ejection fraction (LVEF) (MD: 7.88; 95% CI: 6.67, 9.09; P < 0.01), with a significant reduction in postoperative atrial fibrillation (POAF) (RR: 0.53; 95% CI: 0.30, 0.95; P = 0.03). In contrast, there was no significant reduction in in-hospital mortality (RR: 0.51; 95% CI: 0.10, 2.63; P = 1.00) and stroke incidence (RR: 0.85; 95% CI: 0.12, 5.76; P = 0.82). Conclusion: Preoperative administration of L-carnitine demonstrates meaningful short-term benefits in enhancing CI, LVSWI, and LVEF while reducing the incidence of POAF following cardiac surgery. These findings suggest a potential role for L-carnitine supplementation in optimising perioperative cardiac care, enhancing recovery, and reducing complications following cardiac surgery. However, the existing studies are limited in scope, making it challenging to draw robust conclusions.https://journals.lww.com/10.4103/ija.ija_1325_24cardiac surgerycardioprotectionl-carnitinemeta-analysispostoperative complicationssystematic review |
| spellingShingle | Laila Shalabi Ahmed Ibrahim Mohamed Adel Elsawy Sofian Zreigh Muhiddin Dervis Mohamed N. Elshabrawi Sohaila Mourad Mohamed A. Arafa Mohamed Abuelazm L-carnitine supplementation to prevent postoperative complications after cardiac surgery: A systematic review and meta-analysis of randomised clinical trials Indian Journal of Anaesthesia cardiac surgery cardioprotection l-carnitine meta-analysis postoperative complications systematic review |
| title | L-carnitine supplementation to prevent postoperative complications after cardiac surgery: A systematic review and meta-analysis of randomised clinical trials |
| title_full | L-carnitine supplementation to prevent postoperative complications after cardiac surgery: A systematic review and meta-analysis of randomised clinical trials |
| title_fullStr | L-carnitine supplementation to prevent postoperative complications after cardiac surgery: A systematic review and meta-analysis of randomised clinical trials |
| title_full_unstemmed | L-carnitine supplementation to prevent postoperative complications after cardiac surgery: A systematic review and meta-analysis of randomised clinical trials |
| title_short | L-carnitine supplementation to prevent postoperative complications after cardiac surgery: A systematic review and meta-analysis of randomised clinical trials |
| title_sort | l carnitine supplementation to prevent postoperative complications after cardiac surgery a systematic review and meta analysis of randomised clinical trials |
| topic | cardiac surgery cardioprotection l-carnitine meta-analysis postoperative complications systematic review |
| url | https://journals.lww.com/10.4103/ija.ija_1325_24 |
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