Evaluating the Potential Effect of L-carnitine on the Prevention of AF Following Coronary Artery Bypass Graft Surgery: A Randomised Clinical Trial

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Aim: AF is one of the most common complications in patients who undergo coronary artery bypass graft surgery (CABG). The aim of this study was to evaluate the effect of L-carnitine administration on postoperative AF and acute kidney injury following CABG.

Design and methods: 134 patients undergoing elective CABG, without history of AF or previous L-carnitine treatment, were randomly assigned to an L-carnitine group (3,000 mg/day L-carnitine) or a control group. CRP levels, as a biomarker of inflammation, were assessed in all patients before surgery as baseline levels and 48 hours postoperatively. Neutrophil gelatinase-associated lipocalin (NGAL), a kidney biomarker, was also measured in patients before surgery and 2 hours thereafter.

Results: The incidence of AF was 13.4% in our population. L-carnitine significantly reduced the incidence of postoperative AF (7.5% in the L-carnitine group versus 19.4% in the control group; p=0.043) and postoperative CRP level (8.79 ± 6.9 in the L-carnitine group versus 10.83 ± 5.7 in the control group; p=0.021). Postoperative NGAL concentration demonstrated no significant rise after surgery compared with the preoperative concentration (72.54 ± 20.30 in the L-carnitine group versus 67.68 ± 22.71 in the placebo group; p=0.19).

Conclusion: Our study showed that L-carnitine administration before CABG may inhibit and reduce the incidence of post-CABG AF. It seems that a rise in the CRP level, as an inflammation marker, may be associated with the incidence of AF.