Effect of Nicotinamide Adenine Dinucleotide on Heart Failure Caused by Ischemic Cardiomyopathy: A Randomized, Placebo-Controlled Trial
Abstract
Nicotinamide adenine dinucleotide (NAD+) is a fundamental coenzyme that plays a crucial role in cellular energy metabolism and redox homeostasis. A deficiency in NAD+ has been associated with heart failure (HF), which often occurs in the advanced stages of cardiovascular diseases. While numerous studies have indicated that NAD+ supplementation may enhance cardiac bioenergetics and function in animal models, there is limited research investigating this potential effect in human patients. Therefore, this study aims to evaluate whether NAD+ treatment can lead to improved clinical outcomes for patients with HF due to ischemic cardiomyopathy (ICM). This single-center, prospective, randomized, placebo-controlled trial enrolled 180 adults diagnosed with ICM whose left ventricular ejection fraction (LVEF) was ≤ 45% and whose New York Heart Association (NYHA) grade was II–III. Participants were randomly assigned to receive either intravenous NAD⁺ (10 mg/day) or an equivalent placebo (5% glucose/normal saline) for a duration of 7 days, alongside guideline-directed medical therapy. The primary endpoint was the Change in LVEF at 1 month. Secondary endpoints included changes in N-terminal pro B-type natriuretic peptide (NT-proBNP) at 7 and 30 days; a composite of major adverse cardiac and cerebrovascular events (MACCE), which encompassed cardiac death, non-fatal myocardial infarction, stroke, and the first unplanned HF hospitalization within 6 months; and improvements in NYHA functional…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 180 participants or records.
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