Guest guest Posted January 4, 2006 Report Share Posted January 4, 2006 Hi All, Relevant to the below, is the pdf-available following paper following it introduction. This Week in JAMA JAMA. 2006;295:9. L-Arginine in Acute Myocardial Infarction Prior clinical studies have suggested that L-arginine, a popular health supplement, may reduce vascular stiffness and improve endothelial function in older patients. Schulman and colleagues conducted a randomized, placebo-controlled trial to assess whether adding L-arginine to standard therapy reduces vascular stiffness and improves ejection fraction in patients 6 months after a first ST-segment elevation myocardial infarction. The authors found that compared with placebo, L-arginine did not improve vascular stiffness measures or ejection fraction and may be associated with a higher risk of postinfarction death in those who do not take it. L-Arginine Therapy in Acute Myocardial Infarction: The Vascular Interaction With Age in Myocardial Infarction (VINTAGE MI) Randomized Clinical Trial P. Schulman; C. Becker; A. Kass; Hunter C. Champion; L. Terrin; Forman; Kavita V. Ernst; Mark D. Kelemen; N. Townsend; Anne Capriotti; M. Hare; Gerstenblith JAMA. 2006;295:58-64. ABSTRACT Context The amino acid L-arginine is a substrate for nitric oxide synthase and is increasingly used as a health supplement. Prior studies suggest that L-arginine has the potential to reduce vascular stiffness. Objective To determine whether the addition of L-arginine to standard postinfarction therapy reduces vascular stiffness and improves ejection fraction over 6-month follow-up in patients following acute ST-segment elevation myocardial infarction. Design and Setting Single-center, randomized, double-blind, placebo-controlled trial with enrollment from February 2002 to June 2004. Patients A total of 153 patients following a first ST-segment elevation myocardial infarction were enrolled; 77 patients were 60 years or older. Intervention Patients were randomly assigned to receive L-arginine (goal dose of 3 g 3 times a day) or matching placebo for 6 months. Main Outcome Measures Change in gated blood pool–derived ejection fraction over 6 months in patients 60 years or older randomized to receive L-arginine compared with those assigned to receive placebo. Secondary outcomes included change in ejection fraction in all patients enrolled, change in noninvasive measures of vascular stiffness, and clinical events. Results Baseline characteristics, vascular stiffness measurements, and left ventricular function were similar between participants randomized to receive placebo or L-arginine. The mean (SD) age was 60 (13.6) years; of the participants, 104 (68%) were men. There was no significant change from baseline to 6 months in the vascular stiffness measurements or left ventricular ejection fraction in either of the 2 groups, including those 60 years or older and the entire study group. However, 6 participants (8.6%) in the L-arginine group died during the 6-month study period vs none in the placebo group (P = .01). Because of the safety concerns, the data and safety monitoring committee closed enrollment. Conclusions L-Arginine, when added to standard postinfarction therapies, does not improve vascular stiffness measurements or ejection fraction and may be associated with higher postinfarction mortality. L-Arginine should not be recommended following acute myocardial infarction. --- Jeff Novick <jnovick@...> wrote: > Dietary supplement may harm heart patients: > > CHICAGO (Reuters) - Heart attack patients should avoid the dietary supplement > L-arginine based on a study that was scuttled after six volunteers taking the > over-the-counter supplement died, researchers said on Tuesday. > > The study of 153 people who had had heart attacks and continued to have symptoms > of heart disease found no benefit from taking the supplement sometimes advertised > as having the potential to reduce vascular stiffness. > > L-arginine is also sometimes touted as a treatment for hypertension, angina, heart > failure and sexual dysfunction. > > After six months of a planned two-year study, Dr. Schulman of s Hopkins > Medical Institutions in Baltimore concluded that the supplement did not reduce > vascular stiffness, nor did it improve the heart's ability to pump blood. > > " To the contrary, we noted a possible increased risk of death in older patients > after (heart attack) while taking L-arginine compared with those taking a placebo, > leading to the early termination of the study, " Schulman wrote in the Journal > of the American Medical Association. > > The patients were also taking other medications. None of those taking a placebo > died. > > > Al Pater, PhD; email: old542000@... __________________________________________ DSL – Something to write home about. Just $16.99/mo. or less. dsl. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 4, 2006 Report Share Posted January 4, 2006 Hi All, Relevant to the below, is the pdf-available following paper following it introduction. This Week in JAMA JAMA. 2006;295:9. L-Arginine in Acute Myocardial Infarction Prior clinical studies have suggested that L-arginine, a popular health supplement, may reduce vascular stiffness and improve endothelial function in older patients. Schulman and colleagues conducted a randomized, placebo-controlled trial to assess whether adding L-arginine to standard therapy reduces vascular stiffness and improves ejection fraction in patients 6 months after a first ST-segment elevation myocardial infarction. The authors found that compared with placebo, L-arginine did not improve vascular stiffness measures or ejection fraction and may be associated with a higher risk of postinfarction death in those who do not take it. L-Arginine Therapy in Acute Myocardial Infarction: The Vascular Interaction With Age in Myocardial Infarction (VINTAGE MI) Randomized Clinical Trial P. Schulman; C. Becker; A. Kass; Hunter C. Champion; L. Terrin; Forman; Kavita V. Ernst; Mark D. Kelemen; N. Townsend; Anne Capriotti; M. Hare; Gerstenblith JAMA. 2006;295:58-64. ABSTRACT Context The amino acid L-arginine is a substrate for nitric oxide synthase and is increasingly used as a health supplement. Prior studies suggest that L-arginine has the potential to reduce vascular stiffness. Objective To determine whether the addition of L-arginine to standard postinfarction therapy reduces vascular stiffness and improves ejection fraction over 6-month follow-up in patients following acute ST-segment elevation myocardial infarction. Design and Setting Single-center, randomized, double-blind, placebo-controlled trial with enrollment from February 2002 to June 2004. Patients A total of 153 patients following a first ST-segment elevation myocardial infarction were enrolled; 77 patients were 60 years or older. Intervention Patients were randomly assigned to receive L-arginine (goal dose of 3 g 3 times a day) or matching placebo for 6 months. Main Outcome Measures Change in gated blood pool–derived ejection fraction over 6 months in patients 60 years or older randomized to receive L-arginine compared with those assigned to receive placebo. Secondary outcomes included change in ejection fraction in all patients enrolled, change in noninvasive measures of vascular stiffness, and clinical events. Results Baseline characteristics, vascular stiffness measurements, and left ventricular function were similar between participants randomized to receive placebo or L-arginine. The mean (SD) age was 60 (13.6) years; of the participants, 104 (68%) were men. There was no significant change from baseline to 6 months in the vascular stiffness measurements or left ventricular ejection fraction in either of the 2 groups, including those 60 years or older and the entire study group. However, 6 participants (8.6%) in the L-arginine group died during the 6-month study period vs none in the placebo group (P = .01). Because of the safety concerns, the data and safety monitoring committee closed enrollment. Conclusions L-Arginine, when added to standard postinfarction therapies, does not improve vascular stiffness measurements or ejection fraction and may be associated with higher postinfarction mortality. L-Arginine should not be recommended following acute myocardial infarction. --- Jeff Novick <jnovick@...> wrote: > Dietary supplement may harm heart patients: > > CHICAGO (Reuters) - Heart attack patients should avoid the dietary supplement > L-arginine based on a study that was scuttled after six volunteers taking the > over-the-counter supplement died, researchers said on Tuesday. > > The study of 153 people who had had heart attacks and continued to have symptoms > of heart disease found no benefit from taking the supplement sometimes advertised > as having the potential to reduce vascular stiffness. > > L-arginine is also sometimes touted as a treatment for hypertension, angina, heart > failure and sexual dysfunction. > > After six months of a planned two-year study, Dr. Schulman of s Hopkins > Medical Institutions in Baltimore concluded that the supplement did not reduce > vascular stiffness, nor did it improve the heart's ability to pump blood. > > " To the contrary, we noted a possible increased risk of death in older patients > after (heart attack) while taking L-arginine compared with those taking a placebo, > leading to the early termination of the study, " Schulman wrote in the Journal > of the American Medical Association. > > The patients were also taking other medications. None of those taking a placebo > died. > > > Al Pater, PhD; email: old542000@... __________________________________________ DSL – Something to write home about. Just $16.99/mo. or less. dsl. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 4, 2006 Report Share Posted January 4, 2006 Hi folks: As someone here (is it JR?) keeps reminding us, the dose is important. Consuming so much beta-carotene that your skin acquires a yellowish hue does seem, at least to my intuition, intuitively undesirable; or consuming 1 milligram of chromium a day, when 200 mcg a week seems to be effective; or taking seventy times as much vitamin E than everyone who takes no supplements (which is what you are doing if you take one 400 IU capsule daily) ................. The more I read here the more I am glad I take almost all my supplements just one pill per week. Ca+D is the exception that I take daily, when I remember. Rodney. --- In , " Jeff Novick " <jnovick@p...> wrote: > > Dietary supplement may harm heart patients: > > CHICAGO (Reuters) - Heart attack patients should avoid the dietary supplement L-arginine based on a study that was scuttled after six volunteers taking the over-the-counter supplement died, researchers said on Tuesday. > > The study of 153 people who had had heart attacks and continued to have symptoms of heart disease found no benefit from taking the supplement sometimes advertised as having the potential to reduce vascular stiffness. > > L-arginine is also sometimes touted as a treatment for hypertension, angina, heart failure and sexual dysfunction. > > After six months of a planned two-year study, Dr. Schulman of s Hopkins Medical Institutions in Baltimore concluded that the supplement did not reduce vascular stiffness, nor did it improve the heart's ability to pump blood. > > " To the contrary, we noted a possible increased risk of death in older patients after (heart attack) while taking L-arginine compared with those taking a placebo, leading to the early termination of the study, " Schulman wrote in the Journal of the American Medical Association. > > The patients were also taking other medications. None of those taking a placebo died. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 4, 2006 Report Share Posted January 4, 2006 Hi folks: As someone here (is it JR?) keeps reminding us, the dose is important. Consuming so much beta-carotene that your skin acquires a yellowish hue does seem, at least to my intuition, intuitively undesirable; or consuming 1 milligram of chromium a day, when 200 mcg a week seems to be effective; or taking seventy times as much vitamin E than everyone who takes no supplements (which is what you are doing if you take one 400 IU capsule daily) ................. The more I read here the more I am glad I take almost all my supplements just one pill per week. Ca+D is the exception that I take daily, when I remember. Rodney. --- In , " Jeff Novick " <jnovick@p...> wrote: > > Dietary supplement may harm heart patients: > > CHICAGO (Reuters) - Heart attack patients should avoid the dietary supplement L-arginine based on a study that was scuttled after six volunteers taking the over-the-counter supplement died, researchers said on Tuesday. > > The study of 153 people who had had heart attacks and continued to have symptoms of heart disease found no benefit from taking the supplement sometimes advertised as having the potential to reduce vascular stiffness. > > L-arginine is also sometimes touted as a treatment for hypertension, angina, heart failure and sexual dysfunction. > > After six months of a planned two-year study, Dr. Schulman of s Hopkins Medical Institutions in Baltimore concluded that the supplement did not reduce vascular stiffness, nor did it improve the heart's ability to pump blood. > > " To the contrary, we noted a possible increased risk of death in older patients after (heart attack) while taking L-arginine compared with those taking a placebo, leading to the early termination of the study, " Schulman wrote in the Journal of the American Medical Association. > > The patients were also taking other medications. None of those taking a placebo died. > Quote Link to comment Share on other sites More sharing options...
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