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Comparative study of the efficacy of captopril, simvastatin, and L-carnitine as cardioprotective drugs in children with type 1 diabetes mellitus: a randomised controlled trial

Part of: Interventional Cardiology

Published online by Cambridge University Press:  04 February 2021

Alshimaa Badreldeen ,
Osama El Razaky ,
Adel Erfan ,
Amal El-Bendary  and
Doaa El Amrousy Open the ORCID record for Doaa El Amrousy [Opens in a new window]
Alshimaa Badreldeen
Affiliation:
Pediatric Department, Tanta University Hospital, Tanta, Egypt
Osama El Razaky
Affiliation:
Pediatric Department, Tanta University Hospital, Tanta, Egypt
Adel Erfan
Affiliation:
Pediatric Department, Tanta University Hospital, Tanta, Egypt
Amal El-Bendary
Affiliation:
Clinical Pathology Department, Tanta University, Egypt
Doaa El Amrousy*
Affiliation:
Pediatric Department, Tanta University Hospital, Tanta, Egypt
*
Author for correspondence: Doaa El Amrousy, Assistant Professor of Pediatrics, Tanta University, El Motasem street No 6, Tanta, Egypt. Tel: +201289022229; Fax: +20403282277. E-mail: doaamoha@yahoo.com
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Abstract

Objectives:

To assess the efficacy and safety of captopril, simvastatin, and L-carnitine as cardioprotective drugs in children with type 1 diabetes mellitus on different echocardiographic parameters, electrocardiographic parameter, lipid profile, and carotid intima–media thickness.

Methods:

This randomised controlled trial was conducted on 100 children with type 1 diabetes mellitus for more than 3 years during the period from September 2018 to June 2020. Fifty healthy children of matched age and sex served as a control group. The patients were randomly assigned into four groups (25 children each): no-treatment group who received no cardioprotective drug, simvastatin group who received simvastatin (10–20 mg/day), captopril group who received captopril (0.2 mg/kg/day), and L-carnitine group who received L-carnitine (50 mg/kg/day) for 4 months. Lipid profile, serum troponin I, carotid intima–media thickness, and echocardiographic examinations were performed on all included children before and after the treatment.

Results:

Total cholesterol and low-density lipoprotein were significantly decreased in children who received simvastatin or L-carnitine. Triglycerides significantly decreased only in children who received simvastatin. High-density lipoprotein significantly increased in simvastatin and L-carnitine groups only. Serum troponin I decreased significantly in all the three treatment groups. Carotid intima–media thickness showed no significant change in all treatment groups. Echocardiographic parameters significantly improved in simvastatin, L-carnitine, and captopril groups.

Conclusion:

Captopril, simvastatin, and L-carnitine have a significant beneficial effect on cardiac functions in children with type 1 diabetes mellitus. However, only simvastatin and L-carnitine have a beneficial effect on the lipid profile. The drugs were safe and well tolerated.

Clinical trial registration: The clinical trial was registered at www.clinicaltrial.gov (NCT03660293).

Keywords

Childrenlipid profiletype 1 diabetes mellituscardioprotective drugsasymptomatic cardiac dysfunction3D-STE
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 8 , August 2021 , pp. 1315 - 1322
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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