Iranian Red Crescent Medical Journal

Published by: Kowsar

Effects of Therapeutic Lifestyle Change Diet and Q10 Plus L-Carnitine Supplementation on Inflammatory Biomarkers of In-Stent Restenosis, Lipid Profile, and Left Ventricular Ejection Fraction in Myocardial Infarction: A Randomized Clinical Trial

Mohammad Hossein Sharifi 1 , Mohammad Hassan Eftekhari 1 , * , Mohammad Ali Ostovan 2 and Abbas Rezaianazadeh 3
Authors Information
1 Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz Medical Sciences, Shiraz, IR Iran
2 Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
3 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
Article information
  • Iranian Red Crescent Medical Journal: April 2017, 19 (4); e44868
  • Published Online: February 26, 2017
  • Article Type: Research Article
  • Received: December 28, 2016
  • Revised: January 21, 2017
  • Accepted: February 5, 2017
  • DOI: 10.5812/ircmj.44868

To Cite: Sharifi M H, Eftekhari M H, Ostovan M A, Rezaianazadeh A. Effects of Therapeutic Lifestyle Change Diet and Q10 Plus L-Carnitine Supplementation on Inflammatory Biomarkers of In-Stent Restenosis, Lipid Profile, and Left Ventricular Ejection Fraction in Myocardial Infarction: A Randomized Clinical Trial, Iran Red Crescent Med J. 2017 ; 19(4):e44868. doi: 10.5812/ircmj.44868.

Copyright © 2017, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Introduction
2. Methods
3. Results
4. Discussion
  • 1. Cobb SL, Brown DJ, Davis LL. Effective interventions for lifestyle change after myocardial infarction or coronary artery revascularization. J Am Acad Nurse Pract. 2006; 18(1): 31-9[DOI][PubMed]
  • 2. Jones K, Saxon L, Cunningham W, Adams P, Guideline Development G. Secondary prevention for patients after a myocardial infarction: summary of updated NICE guidance. BMJ. 2013; 347[DOI][PubMed]
  • 3. Endorsed by the Latin American Society of Interventional C, Pci Writing C, Levine GN, Bates ER, Blankenship JC, Bailey SR, et al. 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial Infarction: An update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Catheter Cardiovasc Interv. 2016; 87(6): 1001-19[DOI][PubMed]
  • 4. Murphy BM, Worcester MU, Goble AJ, Mitchell F, Navaratnam H, Higgins RO, et al. Lifestyle and physiological risk factor profiles six weeks after an acute cardiac event: are patients achieving recommended targets for secondary prevention? Heart Lung Circ. 2011; 20(7): 446-51[DOI][PubMed]
  • 5. Seropian IM, Toldo S, Van Tassell BW, Abbate A. Anti-inflammatory strategies for ventricular remodeling following ST-segment elevation acute myocardial infarction. J Am Coll Cardiol. 2014; 63(16): 1593-603[DOI][PubMed]
  • 6. Alfonso F, Byrne RA, Rivero F, Kastrati A. Current treatment of in-stent restenosis. J Am Coll Cardiol. 2014; 63(24): 2659-73[DOI][PubMed]
  • 7. Teirstein PS. Drug-eluting stent restenosis: an uncommon yet pervasive problem. Circulation. 2010; 122(1): 5-7[DOI][PubMed]
  • 8. Niccoli G, Dato I, Imaeva AE, Antonazzo Panico R, Roberto M, Burzotta F, et al. Association between inflammatory biomarkers and in-stent restenosis tissue features: an Optical Coherence Tomography Study. Eur Heart J Cardiovasc Imaging. 2014; 15(8): 917-25[DOI][PubMed]
  • 9. Iwata A, Miura S, Shirai K, Kawamura A, Tomita S, Matsuo Y, et al. Lower level of low-density lipoprotein cholesterol by statin prevents progression of coronary restenosis after successful stenting in acute myocardial infarction. Intern Med. 2006; 45(15): 885-90[PubMed]
  • 10. Hamasaki S, Tei C. Effect of coronary endothelial function on outcomes in patients undergoing percutaneous coronary intervention. J Cardiol. 2011; 57(3): 231-8[DOI][PubMed]
  • 11. Mohan S, Dhall A. A comparative study of restenosis rates in bare metal and drug-eluting stents. Int J Angiol. 2010; 19(2)-72[PubMed]
  • 12. Joviliano EE, Piccinato CE, Dellalibera-Joviliano R, Moriya T, Evora PR. Inflammatory markers and restenosis in peripheral percutaneous angioplasty with intravascular stenting: current concepts. Ann Vasc Surg. 2011; 25(6): 846-55[DOI][PubMed]
  • 13. Niccoli G, Montone RA, Ferrante G, Crea F. The evolving role of inflammatory biomarkers in risk assessment after stent implantation. J Am Coll Cardiol. 2010; 56(22): 1783-93[DOI][PubMed]
  • 14. Hsieh IC, Chen CC, Hsieh MJ, Yang CH, Chen DY, Chang SH, et al. Prognostic Impact of 9-Month High-Sensitivity C-Reactive Protein Levels on Long-Term Clinical Outcomes and In-Stent Restenosis in Patients at 9 Months after Drug-Eluting Stent Implantation. PLoS One. 2015; 10(9)[DOI][PubMed]
  • 15. Bibek SB, Xie Y, Gao JJ, Wang Z, Wang JF, Geng DF. Role of pre-procedural C-reactive protein level in the prediction of major adverse cardiac events in patients undergoing percutaneous coronary intervention: a meta-analysisof longitudinal studies. Inflammation. 2015; 38(1): 159-69[DOI][PubMed]
  • 16. Li JJ, Ren Y, Chen KJ, Yeung AC, Xu B, Ruan XM, et al. Impact of C-reactive protein on in-stent restenosis: a meta-analysis. Tex Heart Inst J. 2010; 37(1): 49-57[PubMed]
  • 17. Mowafy A, El-Akabawy H, Hussein A, Abd El Hay A. Prognostic value of IL6 in young adults presenting with acute coronary syndrome. Egypt Heart J. 2015; 67(2): 151-8[DOI]
  • 18. Noto D, Cottone S, Baldassare Cefalu A, Vadala A, Barbagallo CM, Rizzo M, et al. Interleukin 6 plasma levels predict with high sensitivity and specificity coronary stenosis detected by coronary angiography. Thromb Haemost. 2007; 98(6): 1362-7[PubMed]
  • 19. Verma DD, Hartner WC, Thakkar V, Levchenko TS, Torchilin VP. Protective effect of coenzyme Q10-loaded liposomes on the myocardium in rabbits with an acute experimental myocardial infarction. Pharm Res. 2007; 24(11): 2131-7[DOI][PubMed]
  • 20. Fedacko J. Coenzyme Q10 in Heart and Brain Diseases. Open Nutraceuticals J. 2011; 4(1): 69-87[DOI]
  • 21. Lee BJ, Lin JS, Lin YC, Lin PT. Antiinflammatory effects of L-carnitine supplementation (1000 mg/d) in coronary artery disease patients. Nutrition. 2015; 31(3): 475-9[DOI][PubMed]
  • 22. Lee BJ, Huang YC, Chen SJ, Lin PT. Effects of coenzyme Q10 supplementation on inflammatory markers (high-sensitivity C-reactive protein, interleukin-6, and homocysteine) in patients with coronary artery disease. Nutrition. 2012; 28(7-8): 767-72[DOI][PubMed]
  • 23. Sahebkar A. Effect of L-Carnitine Supplementation on Circulating C-Reactive Protein Levels: A Systematic Review and Meta-Analysis/Uticaj Suplementacije L-Karnitinom Na Nivoe C-Reaktivnog Proteina U Cirkulaciji: Sistematski Pregled I Metaanaliza. J Med Biochem. 2015; 34(2): 151-9
  • 24. Lee BJ, Lin JS, Lin YC, Lin PT. Effects of L-carnitine supplementation on lipid profiles in patients with coronary artery disease. Lipids Health Dis. 2016; 15: 107[DOI][PubMed]
  • 25. Stalin J, Selvamani S, Thirupathi K. A Study on the Lipid Lowering Effect of Coenzyme Q 10 in Dyslipidaemic Patients who Underwent Percutaneous Transluminal Coronary Angioplasty and receive Atorvastatin Therapy. Int J Pharm Res Rev. 2013; 2(9): 1-9
  • 26. Fotino AD, Thompson-Paul AM, Bazzano LA. Effect of coenzyme Q(1)(0) supplementation on heart failure: a meta-analysis. Am J Clin Nutr. 2013; 97(2): 268-75[DOI][PubMed]
  • 27. Tarantini G, Scrutinio D, Bruzzi P, Boni L, Rizzon P, Iliceto S. Metabolic treatment with L-carnitine in acute anterior ST segment elevation myocardial infarction. A randomized controlled trial. Cardiology. 2006; 106(4): 215-23[DOI][PubMed]
  • 28. Huang H, Song L, Zhang H, Zhang H, Zhang J, Zhao W. Influence of L-carnitine supplementation on serum lipid profile in hemodialysis patients: a systematic review and meta-analysis. Kidney Blood Press Res. 2013; 38(1): 31-41[DOI][PubMed]
  • 29. Chen Y, Abbate M, Tang L, Cai G, Gong Z, Wei R, et al. L-Carnitine supplementation for adults with end-stage kidney disease requiring maintenance hemodialysis: a systematic review and meta-analysis. Am J Clin Nutr. 2014; 99(2): 408-22[DOI][PubMed]
  • 30. Catharine R, Benjamin C, Robert JC, Katherine LT, Thomas R, Ziegler M. Modern nutrition in health and disease. 2014;
  • 31. Lin HH, Tsai YF, Lin PJ, Tsay PK. Effects of a therapeutic lifestyle-change programme on cardiac risk factors after coronary artery bypass graft. J Clin Nurs. 2010; 19(1-2): 60-8[DOI][PubMed]
  • 32. Matsumoto I, Miyake Y, Mizukawa M, Takagi Y. Impact of low-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio on long-term outcome in patients undergoing percutaneous coronary intervention. Circ J. 2011; 75(4): 905-10[PubMed]
  • 33. Lee HY, Kim JH, Kim BO, Byun YS, Cho S, Goh CW, et al. Regular exercise training reduces coronary restenosis after percutaneous coronary intervention in patients with acute myocardial infarction. Int J Cardiol. 2013; 167(6): 2617-22[DOI][PubMed]
  • 34. Swardfager W, Herrmann N, Cornish S, Mazereeuw G, Marzolini S, Sham L, et al. Exercise intervention and inflammatory markers in coronary artery disease: a meta-analysis. Am Heart J. 2012; 163(4): 666-76 e1-3[DOI][PubMed]
  • 35. Moghaddam MH, Aghdam F, Jafarabadi MA, Allahverdipour H, Nikookheslat SD, Safarpour S. The Iranian Version of International Physical Activity Questionnaire (IPAQ) in Iran: content and construct validity, factor structure, internal consistency and stability. World Appl Sci. 2012; 18(8): 1073-80
  • 36. Sjostram M, Ainsworth B, Bauman A, Bull F, Craig C, Sallis J. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ)-short and long forms. 2005;
  • 37. Huerta A, Lopez B, Ravassa S, San Jose G, Querejeta R, Beloqui O, et al. Association of cystatin C with heart failure with preserved ejection fraction in elderly hypertensive patients: potential role of altered collagen metabolism. J Hypertens. 2016; 34(1): 130-8[DOI][PubMed]
  • 38. Gordon NF, Salmon RD, Franklin BA, Sperling LS, Hall L, Leighton RF, et al. Effectiveness of therapeutic lifestyle changes in patients with hypertension, hyperlipidemia, and/or hyperglycemia. Am J Cardiol. 2004; 94(12): 1558-61[DOI][PubMed]
  • 39. Kim SH, Lee HL, Ahn GJ, Kim HL, Seo JB, Chung WY, et al. Effect Of Therapeutic Lifestyle Change On High Density Lipoprotein Cholesterol In Patients With Metabolic Syndrome. 2013;
  • 40. Cho KH, Jeong MH, Park KW, Kim HS, Lee SR, Chae JK, et al. Comparison of the effects of two low-density lipoprotein cholesterol goals for secondary prevention after acute myocardial infarction in real-world practice: >/= 50% reduction from baseline versus <70 mg/dL. Int J Cardiol. 2015; 187: 478-85[DOI][PubMed]
  • 41. Schwingshackl L, Hoffmann G. Mediterranean dietary pattern, inflammation and endothelial function: a systematic review and meta-analysis of intervention trials. Nutr Metab Cardiovasc Dis. 2014; 24(9): 929-39[DOI][PubMed]
  • 42. Young D, Camhi S, Wu T, Hagberg J, Stefanick M. Relationships among changes in C-reactive protein and cardiovascular disease risk factors with lifestyle interventions. Nutr Metab Cardiovasc Dis. 2013; 23(9): 857-63[DOI][PubMed]
  • 43. Antonopoulos AS, Margaritis M, Lee R, Channon K, Antoniades C. Statins as anti-inflammatory agents in atherogenesis: molecular mechanisms and lessons from the recent clinical trials. Curr Pharm Des. 2012; 18(11): 1519-30[PubMed]
  • 44. Hosseinpour-Niazi S, Mirmiran P, Fallah-Ghohroudi A, Azizi F. Non-soya legume-based therapeutic lifestyle change diet reduces inflammatory status in diabetic patients: a randomised cross-over clinical trial. Br J Nutr. 2015; 114(2): 213-9[DOI][PubMed]
  • 45. Sjoblom J, Muhrbeck J, Witt N, Alam M, Frykman-Kull V. Evolution of left ventricular ejection fraction after acute myocardial infarction: implications for implantable cardioverter-defibrillator eligibility. Circulation. 2014; 130(9): 743-8[DOI][PubMed]
  • 46. DiNicolantonio JJ, Lavie CJ, Fares H, Menezes AR, O'Keefe JH. L-carnitine in the secondary prevention of cardiovascular disease: systematic review and meta-analysis. Mayo Clin Proc. 2013; 88(6): 544-51[DOI][PubMed]
  • 47. Stocker R, Macdonald P. The benefit of coenzyme Q10 supplements in the management of chronic heart failure: a long tale of promise in the continued absence of clear evidence. Am J Clin Nutr. 2013; 97(2): 233-4[DOI][PubMed]
  • 48. Omori Y, Ohtani T, Sakata Y, Mano T, Takeda Y, Tamaki S, et al. L-Carnitine prevents the development of ventricular fibrosis and heart failure with preserved ejection fraction in hypertensive heart disease. J Hypertens. 2012; 30(9): 1834-44[DOI][PubMed]
  • 49. Xu YL, Li JJ, Xu B, Zhu CG, Yang YJ, Chen JL, et al. Role of plasma C-reactive protein in predicting in-stent restenosis in patients with stable angina after coronary stenting. Chin Med J (Engl). 2011; 124(6): 845-50[PubMed]
  • 50. Ritschel VN, Seljeflot I, Arnesen H, Halvorsen S, Weiss T, Eritsland J, et al. IL-6 signalling in patients with acute ST-elevation myocardial infarction. Results Immunol. 2014; 4: 8-13[DOI][PubMed]
  • 51. Shojaei M, Djalali M, Khatami M, Siassi F, Eshraghian M. Effects of carnitine and coenzyme Q10 on lipid profile and serum levels of lipoprotein(a) in maintenance hemodialysis patients on statin therapy. Iran J Kidney Dis. 2011; 5(2): 114-8[PubMed]
  • 52. Sander S, Coleman CI, Patel AA, Kluger J, White CM. The impact of coenzyme Q10 on systolic function in patients with chronic heart failure. J Card Fail. 2006; 12(6): 464-72[DOI][PubMed]
  • 53. Bellenger NG, Marcus NJ, Davies C, Yacoub M, Banner NR, Pennell DJ. Left ventricular function and mass after orthotopic heart transplantation: a comparison of cardiovascular magnetic resonance with echocardiography. J Heart Lung Transplant. 2000; 19(5): 444-52[PubMed]
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments