Melatonin for Heart Attack and Stroke: Health Benefits and Studies

I have been commenting on the value of melatonin for many human health issues for years, but science is now suggesting that melatonin may have health-promoting and possibly life-protecting effects if taken quickly after a heart attack or stroke compared to a placebo group.

In this first study, we see that melatonin taken soon after a heart attack (within 3 hours) as an intravenous infusion  (12 mg per 50 ml) was associated with better patient outcomes two years after acute myocardial infarction (AMI), as discussed here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000067/

Here is a relevant quote from the pilot randomized controlled trial (RCT) which had 94 participants :

The results of this pilot study indicate that treatment with intravenous melatonin in patients with AMI undergoing primary percutaneous coronary intervention is associated with a reduced incidence of death or readmission due to heart failure. This effect was accompanied by a substantial treatment-related difference in MMP-9 levels, a marker of AMI remodeling response.

Here is a graph representing the difference between those who received a placebo and those who received just one dose of melatonin :

Of important interest in this study is that melatonin was only given once shortly after symptoms developed and still had a positive impact on the 2 year outcomes for these participants. My question about this study is, what would have happened to the melatonin group had they taken melatonin orally daily for the full 2 years study period instead of just once at the beginning of the study?

In this next research, it is shown that 10 mg of melatonin taken every night for  24 weeks has beneficial effects on the cardiovascular system and might advantage heart failure with reduced ejection fraction (HFrEF) by attenuating the effects of the renin-angiotensin-aldosterone and sympathetic system on the heart besides its antioxidant and anti-inflammatory effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019884/

Here is a relevant quote from the trial involving 85 participants :

Serum NT‐Pro BNP decreased significantly in the melatonin compared with the placebo group (estimated marginal means for difference [95% confidence interval]: 111.0 [6.2–215.7], p = .044). Moreover, the melatonin group had a significantly better clinical outcome (0.93 [0.18–1.69], p = .017), quality of life (5.8 [0.9–12.5], p = .037), and New York Heart Association class (odds ratio: 12.9 [1.6–102.4]; p = .015) at the end of the trial. Other studied outcomes were not significantly different between groups.

In the above study, melatonin was given daily, but it doesn't appear that it was given within 3 hours of the cardiac event, a point other studies have emphasized as important in obtaining the best results. My thinking is that both early intervention within 3 hours of the event and daily melatonin supplementation after the event may offer better results.

The following review regarding melatonin and stroke covers a lot of ground and reaches some interesting conclusions :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463751/

Here is a relevant quote from the literature review:

Stroke stands as a prominent agent of cognitive impairment and mortality worldwide and unfortunately has limited treatment options. Therefore, novel therapies like melatonin are crucial to attenuating stroke’s devastating effects. Melatonin acts as an antioxidant and free radical scavenger, ameliorating neuroinflammation and accelerating brain tissue restoration. Preclinical studies utilizing animal stroke models and clinical trials with stroke patients have been conducted to investigate melatonin’s therapeutic potency in the context of stroke. Experimental stroke models in vitro and in vivo have demonstrated melatonin’s neuroprotective capabilities, as melatonin reduces infarct size and enhances glial cell viability. Melatonin delivered exogenously displays substantial therapeutic effects but results fluctuate with changing melatonin levels.

So a major point of using melatonin for these purposes seems to be that early implementation of melatonin is a very important aspect of melatonin intervention. The chances seem highly unlikely that a hospital or emergency room is going to give you melatonin, so for me, personally, this would mean that I would have to carry melatonin with me in order to make sure I utilize it in a timely manner during a heart attack or stroke. Again, only speaking for myself and discussing what I would do for myself during a heart attack or stroke, I would use both oral melatonin and melatonin lotion to maximize absorption and availability to as much of the body as possible and continue using melatonin far beyond the cardiovascular event.

A downside to the use of melatonin during a stroke is that often times swallowing of anything may cause choking or asphyxiation, so for me, if the stroke is so bad that I can not safely swallow melatonin or water, I would freely use melatonin lotion by itself on my body.

I discuss the making and use of melatonin lotion by several friends here :

Topical Melatonin Lotion for Pain Relief: Recipe + Success Stories

Warning 

Although melatonin has a very good safety profile on its own, the studies on the use of melatonin in people having strokes or heart attacks are still limited and are done under controlled hospital settings and for the purpose of being as safe as is possible, anyone considering melatonin for heart attack or stroke must have their physician's and or cardiologist's approval and supervision in order to do so. Another consideration is that melatonin may not be compatible with every medication you may receive in the hospital or emergency room, so medical supervision by your doctor and or cardiologist is an absolute must.

Art

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Topical Melatonin Lotion for Pain Relief: Recipe + Success Stories