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Inclusion criteria This review considered peer-reviewed studies of L-carnitine supplementation in subjects with coronary artery disease across predefined designs, each with a distinct role, including preclinical evidence such as animal studies which provided mechanistic evidence and insights on emerging pathways, as well as clinical evidence such as case reports, cross-sectional studies, observational studies, retrospective analyses, randomized controlled trials, systematic review and meta-analyses which provided primary evidence as well as quantitative analysis of clinical endpoints

Dysfunctional adipose tissue promotes increased cardiovascular and diabetes disease risk via multiple pathways including increased free fatty acids (FFA) in the liver, infiltration of visceral fat deposits by proinflammatory macrophages resulting in chronic low-grade inflammation, and reduced buffering capacity for protective lipid storage [7]