Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: Dr Schulman and colleagues1 examined the effect of 6-month arginine supplementation on the outcome of patients with acute ST-segment elevation myocardial infarction. The premise of the study was that arginine, as a unique precursor for nitric oxide synthesis, would be beneficial in reducing vascular stiffness and other parameters of myocardial function following acute myocardial infarction. The study was stopped prior to enrollment of the targeted number of patients because of lack of cardiovascular efficacy as well as increased mortality in the arginine treatment group. The authors conclude that arginine should not be recommended following acute myocardial infarction. Before accepting this recommendation and dismissing the study premise, several factors need to be considered.
Abumrad NN, Barbul A. Arginine Therapy for Acute Myocardial Infarction. JAMA. 2006;295(18):2138-2140. doi:10.1001/jama.295.18.2138-b