Critical update for the clinical use of L-carnitine analogs in cardiometabolic disorders

Vasc Health Risk Manag. 2011:7:169-76. doi: 10.2147/VHRM.S14356. Epub 2011 Mar 28.


Acetyl-L-carnitine (ALC) and propionyl-L-carnitine (PLC) are two naturally occurring carnitine derivates formed by carnitine acetyltransferase. The beneficial cardiovascular effects of ALC and PLC have been extensively evaluated in animals and humans during the last 20 years. For instance, many clinical trials have suggested ALC and PLC as potential strategies in the management of peripheral arterial disease, heart and cerebral ischemia, and congestive heart failure. As a result, several experts have already aimed to revise the clinical evidence supporting the therapeutic use of ALC and PLC. On the basis of their conclusions, our aim was a critical review of the effectiveness of ALC and PLC in the treatment of cardiovascular diseases. Type 2 diabetes mellitus is an independent risk factor for the development of cardiovascular disease. Therefore we also describe recent studies that have addressed the emerging use of ALC and PLC amelioration of the insulin resistant state and its related morbidities.

Keywords: L-carnitine; acetyl-L-carnitine; cardiovascular diseases; insulin resistance; propionyl-L-carnitine.

Publication types

  • Review

MeSH terms

  • Acetylcarnitine / therapeutic use*
  • Animals
  • Cardiovascular Agents / therapeutic use*
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / physiopathology
  • Carnitine / analogs & derivatives*
  • Carnitine / therapeutic use
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / physiopathology
  • Evidence-Based Medicine
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin Resistance
  • Treatment Outcome


  • Cardiovascular Agents
  • Hypoglycemic Agents
  • propionylcarnitine
  • Acetylcarnitine
  • Carnitine