title: Oral L-arginine supplementation in acute myocardial infarction therapy: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The objective was to analyze completed trials assessing the effect of oral L-arginine supplementation on clinical outcomes of patients with acute myocardial infarction (AMI).
  
  
  BACKGROUND
  Prior trials suggest that oral L-arginine administration improves endothelial function in patients with stable coronary artery disease (CAD). However, it is still unclear whether oral supplementation of L-arginine has any effect on clinical outcomes in patients with unstable CAD, such as AMI.
  
  
  METHODS
  We systematically searched PubMed, Cochrane Library, Embase, reviews, and reference lists of relevant articles. The search strategy paired the term "arginine" with the following: "coronary heart disease," "myocardial infarction," "cardiovascular disease," "ischemia," and "trial." We conducted a meta-analysis of randomized, placebo-controlled L-arginine supplementation trials that evaluated clinical outcomes in AMI patients. Two reviewers independently assessed the trials. Differences were resolved by consensus.
  
  
  RESULTS
  Only 2 trials (927 participants) were included. None of the 2 studies showed a significant difference in event rate between the L-arginine and placebo groups. In an overall pooled estimate, there was a 7% reduction in mortality in the L-arginine treatment group (105/459, 22.9%) compared with the control group (111/455, 24.4%), which did not reach statistical significance (risk ratio [RR]: 0.93, 95% confidence interval [CI]: 0.74-1.17; P = 0.54).
  
  
  CONCLUSIONS
  Oral L-arginine supplementation has no effect on the clinical outcomes of patients with AMI.
authors: Department of Cardiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, P.R. China.
authors: Tao
authors: T
authors: Sun
authors: Wen-Bai
authors: WB
authors: Zhou
authors: Xin-Ping
authors: XP
authors: Luo
authors: Yao-Liang
authors: YL
authors: Tang
authors: Hai-Ming
authors: HM
authors: Shi
mesh_terms: D000284:Administration, Oral; D001120:Arginine / Q000008:administration & dosage*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D004311:Double-Blind Method; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D001120:Arginine