title: L-Carnitine Supplementation Reduces Short-Term Neutrophil-Lymphocyte Ratio in Patients Undergoing Coronary Artery Bypass Grafting.
abstract: This study aims to investigate whether preoperative L-carnitine supplementation affects the neutrophil-to-lymphocyte ratio (NLR) in patients undergoing coronary artery bypass grafting surgery. The neutrophil-to-lymphocyte ratio is an inflammatory marker that has proven usefulness for predicting postoperative complications in coronary artery bypass surgery. A lot of studies concerning the role of L-carnitine in the immune system have been performed, contradictory results have been reported on its effects on absolute numbers of WBC subtypes. This randomized, double-blinded, placebo-controlled study was conducted among patients scheduled for coronary artery bypass grafting surgery between June 2012 and December 2013 in our cardiovascular surgery clinic. A total of 60 consecutive patients were randomized and divided into 2 groups. The first group received 2 g of L-carnitine in 1000 mL of 0.9% saline solution infused over 24 hours for each of the 3 preoperative days (L-carnitine group, n = 30), or only 1000 mL of 0.9% saline solution for the same time period (placebo group, n = 30). The basal values of leukocyte, neutrophil, lymphocyte counts, and neutrophil to lymphocyte ratio were similar in the 2 groups. After L-carnitine supplementation (just before surgery), leukocyte and neutrophil counts of the L-carnitine group were significantly lower than those of the placebo group (7.7 ± 1.5 versus 9.7 ± 2.6, P < 0.001 and 4.6 ± 1.3 versus 6.5 ± 2.2, P < 0.001). On postoperative day 1, lymphocyte counts were significantly higher in the L-carnitine group (1.1 ± 0.6 versus 0.8 ± 0.9, P < 0.001). Moreover, the increase in NLR was significantly lower in the L-carnitine group at postoperative day 1 (20.7 ± 13.8 versus 10.8 ± 4.1, P < 0.001). Preoperative L-carnitine supplementation may reduce neutrophil-lymphocyte ratio during the early postoperative period of coronary artery bypass grafting surgery.
authors.affiliation: 1 Afyon Kocatepe University, Faculty of Medicine, Cardiovascular Surgery, Afyonkarahisar, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aldemir
authors.affiliation: 2 Afyon Kocatepe University, Faculty of Medicine, Medical Pharmacology, Afyonkarahisar, Turkey.
authors.forename: Mehmet Bilgehan
authors.initials: MB
authors.lastname: Pektaş
authors.affiliation: 3 Private Akut Cardiovascular Hospital, Cardiovascular Surgery, Izmir, Turkey.
authors.forename: Ali İhsan
authors.initials: Aİ
authors.lastname: Parlar
authors.affiliation: 4 Afyon Kocatepe University, Faculty of Medicine, Cardiology, Afyonkarahisar, Turkey.
authors.forename: Önder
authors.initials: Ö
authors.lastname: Akcı
authors.affiliation: 5 Afyon State Hospital, Cardiology, Afyonkarahisar, Turkey.
authors.forename: Sadık Volkan
authors.initials: SV
authors.lastname: Emren
authors.affiliation: 1 Afyon Kocatepe University, Faculty of Medicine, Cardiovascular Surgery, Afyonkarahisar, Turkey.
authors.forename: Evren
authors.initials: E
authors.lastname: Tecer
authors.affiliation: 1 Afyon Kocatepe University, Faculty of Medicine, Cardiovascular Surgery, Afyonkarahisar, Turkey.
authors.forename: Fahri
authors.initials: F
authors.lastname: Adalı
authors.affiliation: 6 Afyon Kocatepe University, Faculty of Medicine, Internal Medicine, Afyonkarahisar, Turkey.
authors.forename: Şeref
authors.initials: Ş
authors.lastname: Yüksel
authors.affiliation: 1 Afyon Kocatepe University, Faculty of Medicine, Cardiovascular Surgery, Afyonkarahisar, Turkey.
authors.forename: Osman Tansel
authors.initials: OT
authors.lastname: Darçın
mesh_terms: D000368:Aged; D002331:Carnitine / Q000627:therapeutic use*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000276:immunology / Q000601:surgery*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D011300:Preoperative Care
chemical_list: D002331:Carnitine
keywords: Coronary artery bypass grafting; L-carnitine; Neutrophil-to-lymphocyte ratio