Angina: Propionyl-L-Carnitine and Diltiazem Each Helped: In a DB study of 46 patients, researchers found a decrease in angina episodes from both meds in range of 57%-70%. Bartels, Eur Heart J ’96;17:414

Angina Helped by Propionyl Carnitine: In a DB PC study of 12 stable angina patients, propionyl-L-carnitine significantly increased total work from 514 to 600 W (P <0.05) (17%) and prolonged exercise time and time to ischemic threshold from 515 to 565 sec (P <0.05) (10%) and from 375 to 427 sec (P <0.01) (14%). ST segment depression at the highest common work level was significantly reduced from 0.19 to 0.15 mV (P <0.05) (21%). No side effects were observed under propionyl-L-carnitine treatment. Propionyl-L-carnitine: a new compound in the metabolic approach to the treatment of effort angina. Lagioia R, Scrutinio D, et al. Bari, Italy. Int J Cardiol. 1992 Feb;34(2):167-72.

Angina: Propionyl Carnitine Helped: In a 30-day DB PC crossover study of 18 men with stable effort angina, propionyl carnitine (PC) 500 mg three times a day increased both the 1 mm ST-segment depression time and the time to the end of exercise. Furthermore, the drug reduced the ischemic depression of ST at maximal common work and at maximal work. Propionyl carnitine in stable effort angina. Cherchi A, Lai C, et al. University of Cagliari, Italy. Cardiovasc Drugs Ther. 1990 Apr;4(2):481-6.

Angina: L-Propionylcarnitine Helped as did Diltiazem: In a 6-week each DB PC crossover study of 46 stable, exercise-induced angina patients, L-propionylcarnitine 1500 mg/day or calcium channel blocking blood pressure medicine diltiazem (180 mg daily for 3 weeks, followed by 360 mg daily for 3 weeks), researchers found both treatments resulted in comparable exercise duration (582 s and 588 s), time to 0.1 mV ST depression (436 s and 465 s), and increase in time to 0.1 mV ST depression from baseline (20% and 28%). Diltiazem decreased the rate-pressure product at rest and exercise, L-propionylcarnitine did not. Both compounds significantly reduced ST depression at maximal exercise [23% (L-propionylcarnitine) vs 35% (diltiazem), P < 0.05 diltiazem vs L-propionylcarnitine]. Diltiazem increased the time to onset of angina by 22%. No significant changes occurred with L-propionylcarnitine. Anginal attacks were reduced by 70% and 57%. Nitroglycerin consumption decreased by 57% and 70%. Anti-ischaemic efficacy of L-propionylcarnitine--a promising novel metabolic approach to ischaemia? Bartels GL, Remme WJ, Holwerda KJ, Kruijssen DA. Rotterdam, The Netherlands. Eur Heart J. 1996 Mar;17(3):414-20. Ed: Since both drugs help in very different ways, it is likely that both together would work even better than one alone.

Angina: L-Propionylcarnitine Minor Benefit: In a 74-patient DB PC study of angina (2+ attacks per week), L-propionylcarnitine 500 mg 3 times a day for 6 weeks did not affect heart rate, blood pressure at rest, and maximal exercise. L-propionylcarnitine increased the time to 0.1 mV ST-segment depression [44 vs. 8 seconds; p = 0.05], and exercise duration improved by 5%. Anginal attacks and the consumption of nitroglycerin were not affected in either group. Additional antiischemic effects of long-term L-propionylcarnitine in anginal patients treated with conventional antianginal therapy. Bartels GL, Remme WJ, den Hartog FR, Wielenga RP, Kruijssen DA., Rotterdam, Netherlands. Cardiovasc Drugs Ther. 1995 Dec;9(6):749-53

Angina: L-Propionylcartinine Protected Heart Muscle in Angina Patients: In a DB PC crossover trial of 31 angina patients with left coronary artery disease, 15 mg/kg of LPC did not affect myocardial oxygen demand and supply, but did diminish myocardial ischemia with a significant 12% and 50% reduction in ST-segment depression and left ventricular end-diastolic pressure. The left ventricular ejection fraction increased by 18% (p < 0.05). LPC improved recovery of myocardial function after pacing, with a reduction in the time to peak filling and a 21% increase in both peak ejection and filling rates 10 minutes after pacing (all p < 0.05). It increased pyruvate dehydrogenase activity and flux through the citric acid cycle. Effects of L-propionylcarnitine on ischemia-induced myocardial dysfunction in men with angina pectoris. Bartels GL, Remme WJ, Pillay M, Schonfeld DH, Kruijssen DA., Rotterdam, The Netherlands. Am J Cardiol. 1994 Jul 15;74(2):125-30. 

Chronic Fatigue Syndrome: Carnitines Appear to Help: In a 24-week open, but randomized study of 30 chronic fatigue patients given 2 g/d acetyl-L-carnitine, 2 g/d propionyl-L-carnitine, or the combination, considerable improvement was reported in 59% of acetylcarnitine, 63% propionylcarnitine and 37% for the combo. Acetylcarnitine significantly improved mental fatigue (p =.015) and propionylcarnitine improved general fatigue (p =.004). Attention concentration improved in all groups, whereas pain complaints did not. Two weeks after treatment, worsening of fatigue was experienced by 52%, 50%, and 37%, respectively. Exploratory open label, randomized study of acetyl- and propionylcarnitine in chronic fatigue syndrome. Vermeulen RC, Scholte HR., Amsterdam, Netherlands. Psychosom Med. 2004 Mar-Apr;66(2):276-82 

Congestive Heart Failure: Propionyl-L-Carnitine Helped in Two Studies: In a 60-patient DB PC trial, using 500 mg PC per day as an add-on drug led to a 26% increase in exercise capacity after six months. Mancini M, Rengo F, Lingetti M, et al. Controlled study on the therapeutic efficacy of propionyl-L-carnitine in patients with congestive heart failure. Arzneimittelforschung 1992;42:1101-4.; It also helped left ventricular function in a DB PC study in the Eur Heart J 9/94.  

Congestive Heart Failure: Propionyl-L-Carnitine Helped: In a DB PC study, patients with congestive heart failure given 1.5 grams PC daily for 15 days had a 21% increase in exercise tolerance and a 45% increase in oxygen consumption. Anand I, Chandrashenkhan Y, De Giuli F, et al. Acute and chronic effect of propionyl-L-carnitine on the hemodynamics, exercise capacity and hormones of patients with congestive heart failure. Cardiovasc Drugs Ther 1998;12:291-9.

Congestive Heart Failure: PC Minimal Benefit for Exercise Tolerance: In a large DB PC study of 537 mild-moderate chronic heart failure patients on ACE inhibitors and diuretics, there was a non-significant 15 second advantage in exercise tolerance for 1 g/day of propionyl-L-carnitine in the completer/complier population (P=0.092). There were no safety issues. Study on propionyl-L-carnitine in chronic heart failure. Eur Heart J. 1999 Jan;20(1):70-6

Congestive Heart Failure: Propionyl-L-Carnitine Helped: In a 6-month DB PC study of 50 adults ages 48-69 with congestive heart failure on digitalis and diuretic treatment, 1 g b.i.d of propionyl-L-carnitine increased maximum exercise time on the treadmill 11.1% after 90 days and 16.4% after 180 days. The ejection fraction increased by 12.1% at 180 days. Systemic vascular resistances were reduced by 20.6% at 180 days. The placebo showed no significant variation. No toxic effects were observed. The clinical and hemodynamic effects of propionyl-L-carnitine in the treatment of congestive heart failure. Pucciarelli G, Mastursi M, et al. Naples, Italy. Clin Ter. 1992 Nov;141(11):379-84.

Intermittent Claudication: Propionyl-L-Carnitine Helps: PLC helps increase the citric energy cycle in ischemic muscle and it increases pyruvate dehydrogenase activity. In a DB phase III study of peripheral artery disease, patients taking 1-3 g/day improved their maximum walking distance. Wiseman, Drugs Aging 3/98; In a 12-month 485 patient DB PC trial of 1 g/day, PLC improved waling and initial claudication distances in patients previously only able to walk 250 feet. G Brevetti et al. European multicenter study on propionyl-L-carnitine in intermittent claudication. J Am Coll Cardiol 1999 Nov 1;34(5):1618-24

Intermittent Claudication: Propionyl-L-carnitine Helped in 3 Studies: In a DB PC study, PLC did not help patients with a basal max walking distance of over 250 meters but helped those who were more impaired. Naples, Am J Cardiol ’97;79:777; PLC 1-3 g/day increased walking distance but not initial claudication distance in a 24-week DB PC study of 112 patients. Brevetti, Italy, J Am Coll Cardiol ‘95;26:1411; In a 6-month 155-patient DB PC study using 2 g/day, PLC increased time to onset of pain and maximal walking time. WR Hiatt et al. Propionyl-L-carnitine improves exercise performance and functional status in patients with claudication. Am J Med 2001;110:616.

Intermittent Claudication: PC Helped Walking Time and Muscle Strength: In a DB PC crossover study of 6 adults with peripheral arterial disease and intermittent claudication, PLC  2 g/day, increased maximal walking time 14%. Muscle strength increased significantly from 695 N to 812 N.  Effect of propionyl-L-carnitine on exercise performance in peripheral arterial disease. Barker GA, Green S, et al. Queensland University, Brisbane, Australia. Med Sci Sports Exerc. 2001 Sep;33(9):1415-22.

Peyronie's disease: Propionyl-L-Carnitine + Verapamil Helped: Propionyl-l-carnitine plus verapamil significantly reduced penile curvature, plaque size, cavernosal artery end-diastolic velocity, the need for surgery and disease progression, and increased the International Index of Erectile Function score and resistivity index of the cavernosal arteries. Tamoxifen plus verapamil had none of these effects. Two DB random assignment studies of 75 Peyronie's patients found oral propionyl-l-carnitine and intraplaque verapamil in the therapy of advanced and resistant Peyronie's disease. G. Cavallini, G. Biagiotti, A. Koverech and G. Vitali. BJU International 2002;89:895

Sex Dysfunction, Depression, Fatigue in Aging Males: Carnitines a Little Better Than Testosterone: In a 120-patient 6-month DB PC study of men average age 66, testosterone undecanoate 160 mg/day, or propionyl-L-carnitine 2 g/day plus acetyl-L-carnitine 2 g/day or placebo was given. Testosterone and carnitines significantly improved the peak systolic velocity, end-diastolic velocity, resistive index, nocturnal penile tumescence, International Index of Erectile Function score, Depression Melancholia score, and fatigue score. Carnitines were more active in improving nocturnal penile tumescence and erectile function. Testosterone increased prostate volume and free and total testosterone levels and lowered serum luteinizing hormone; carnitines did not. No drug significantly modified prostate-specific antigen or prolactin. Carnitine versus androgen administration in the treatment of sexual dysfunction, depressed mood, and fatigue associated with male aging. Cavallini G, Caracciolo S, Vitali G, Modenini F, Biagiotti G. Bologna, Italy. Urology. 2004 Apr;63(4):641-6

Sex Dysfunction: Impotence Helped  in Diabetic Men: In a DB PC study of 40 men with erectile dysfunction and diabetes, when compared to patients using sildenafil 50 mg twice a week, those taking an additional 2 g/day of propionyl-L-carnitine for 24 weeks had much better erectile dysfunction scores: 4.25 and 3.95 vs. 2.9 and 2.7 (p < 0.01). The percentage of patients with improved erections (GEQ 68% vs. 23%) and successful intercourse attempts (76% vs. 34%) was significantly increased. Two patients reported mild gastric pain on PLC. Preliminary observations on the use of propionyl-L-carnitine in combination with sildenafil in patients with erectile dysfunction and diabetes. Gentile V, Vicini P, Prigiotti G, Koverech A, Di Silverio F. University 'La Sapienza', Rome, Italy. Curr Med Res Opin. 2004 Sep;20(9):1377-84