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Another commenter expressed concern that patients with left ventricular systolic dysfunction may have contraindications to ACEi/ARB/ARNI therapy and recommended that CMS include necessary exclusions for clinically justified cases

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By inhibiting NNMT, 5-Amino-1MQ may spare nicotinamide for NAD+ synthesis, thereby activating SIRT1 (Sirtuin 1) pathways associated with mitochondrial biogenesis and fat oxidation [3]

whether supplementation meaningfully raises intracellular glutathione in specific tissues is more variable

*J Appl Physiol.* 110(3):774-780