Yes, controlled trials have tested IV NAD⁺ in people with heart failure. One found a favorable change in a measure of heart pumping function; another did not find statistically significant differences in its main cardiac measures. A separate oral nicotinamide riboside trial primarily tested safety and blood NAD⁺. None establishes that a wellness drip prevents heart disease or prolongs life. [1][2][3]
This distinction corrects two misleading shortcuts: saying there are no human IV trials, and treating any positive cardiac finding as proof of general rejuvenation. Our IV benefits assessment concerns wellness claims. The trials below recruited people with diagnosed heart failure and continued their usual medical care.
Three studies, three different questions
| Study and participants | Design and outcome | Finding | Main limit |
|---|---|---|---|
| Yu et al.; 180 adults with ischemic cardiomyopathy [1] | Randomized IV NAD⁺ versus placebo plus usual care; one-month ejection fraction | 45.44% vs 42.44%; p = 0.024. Six-month clinical-event difference not significant. | Single center; insufficient power for clinical events. |
| Pei et al.; 60 heart-failure patients [2] | Randomized NAD⁺ versus saline plus usual care; seven-day cardiac and blood markers | Ejection-fraction and NT-proBNP differences were not statistically significant. | Short follow-up; retrospective registration. |
| Wang et al.; 30 stable HFrEF patients [3] | Randomized oral NR versus placebo; safety and NAD⁺ response | Blood NAD⁺ approximately doubled; generally tolerated. | Not powered to establish improvement in heart-failure outcomes. |
What the 180-patient trial supports
Yu and colleagues enrolled patients with heart failure caused by ischemic cardiomyopathy: heart muscle dysfunction associated with impaired blood supply. This was a single-center, randomized, placebo-controlled study. IV NAD⁺ was added to guideline-directed therapy for seven days; it did not replace that therapy. The primary endpoint was change in left ventricular ejection fraction at one month. Ejection fraction describes the share of blood pumped out of the ventricle with each beat. [1]
At one month, the reported average ejection fractions were 45.44% in the NAD⁺ group and 42.44% in the placebo group, with a between-group p value of 0.024. That finding deserves to be reported. It is narrower than showing fewer deaths, strokes or hospital admissions. The six-month composite of major cardiac and cerebrovascular events was 14.6% versus 24.7%, but the difference was not statistically significant (p = 0.089). The study was not sufficiently powered for those relatively infrequent clinical events. [1]
A nonsignificant event result does not prove that there is no possible benefit. It means this study did not establish one. A headline that describes the lower numerical event rate as a proven reduction omits the uncertainty that matters most to a patient.
The smaller study is not independent confirmation of every claim
Pei and colleagues randomized 60 patients to NAD⁺ or saline alongside conventional heart-failure treatment. After seven days, changes in ejection fraction and NT-proBNP, a blood marker used in assessing heart failure, favored NAD⁺ numerically but were not statistically significant. Several oxidative-stress and endothelial markers differed. Those laboratory findings cannot turn a nonsignificant cardiac comparison into a proven clinical benefit. The registration was retrospective, another reason to examine the methods rather than rely on the optimistic conclusion alone. [2]
The studies also used different preparations, doses and populations. They are not replications of a retail infusion package. Questions about route and formulation are explained in oral precursors versus injected NAD⁺.
Why the oral NR trial belongs in a separate column
Wang and colleagues studied 30 people with stable heart failure and reduced ejection fraction. Oral NR approximately doubled whole-blood NAD⁺ and was generally well tolerated over the study period. Associations with immune-cell respiration and inflammatory gene expression supported further investigation. The authors explicitly stated that the trial was underpowered to draw positive or negative conclusions about the exploratory heart-failure outcomes. [3]
NR is a precursor the body can use to make NAD⁺. It is not the same intervention as putting NAD⁺ into a vein. A blood-cell response also does not demonstrate a corresponding change inside heart muscle. The broader NR benefits review explains why target engagement and patient benefit are separate outcomes.
What would change the answer?
More persuasive evidence would include larger multicenter trials with prespecified clinical endpoints, sufficient follow-up and enough events to assess hospitalization and survival reliably. Repeated measurement of pumping function can be useful, but the central question is whether people feel better, function better or experience fewer serious events while receiving contemporary standard care.
These papers justify continued research. They do not supply a self-treatment regimen, a reason to stop prescribed heart-failure medicines or a basis for buying a wellness infusion. Readers considering research participation can use our clinical-trial registry guide to distinguish an approved study protocol from a commercial treatment offer.