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CoQ10 improves outcomes in heart failure patients

November 28 2014

by Emily Ryan

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This randomized controlled trial looked at the use of CoenzymeQ10 as an add-on therapy in patients with chronic heart failure. They found that Long-term CoQ10 treatment of patients with chronic heart failure is safe, improves symptoms, and reduces major adverse cardiovascular events. This adds to a previous body of evidence showing benefit.

This study should change the standard of care for heart failure patients in that Coenzyme Q10 should be used as an add-on therapy. This study used the ubiquinone rather than ubiquinol form of CoQ10.

The Effect of Coenzyme Q10 on Morbidity and Mortality in Chronic Heart Failure: Results From Q-SYMBIO: A Randomized Double-Blind Trial

Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D, Alehagen U, Steurer G, Littarru GP; Q-SYMBIO Study Investigators.

JACC Heart Fail. 2014 Sep 25. pii: S2213-1779(14)00336-9. doi: 10.1016/j.jchf.2014.06.008. [Epub ahead of print]

Abstract

OBJECTIVES:
This randomized controlled multicenter trial evaluated coenzyme Q10 (CoQ10) as adjunctive treatment in chronic heart failure (HF).

BACKGROUND:
CoQ10 is an essential cofactor for energy production and is also a powerful antioxidant. A low level of myocardial CoQ10 is related to the severity of HF. Previous randomized controlled trials of CoQ10 in HF were underpowered to address major clinical endpoints.

METHODS:
Patients with moderate to severe HF were randomly assigned in a 2-year prospective trial to either CoQ10 100 mg 3 times daily or placebo, in addition to standard therapy. The primary short-term endpoints at 16 weeks were changes in New York Heart Association (NYHA) functional classification, 6-min walk test, and levels of N-terminal pro-B type natriuretic peptide. The primary long-term endpoint at 2 years was composite major adverse cardiovascular events as determined by a time to first event analysis.

RESULTS:
A total of 420 patients were enrolled. There were no significant changes in short-term endpoints. The primary long-term endpoint was reached by 15% of the patients in the CoQ10 group versus 26% in the placebo group (hazard ratio: 0.50; 95% confidence interval: 0.32 to 0.80; p = 0.003) by intention-to-treat analysis. The following secondary endpoints were significantly lower in the CoQ10 group compared with the placebo group: cardiovascular mortality (9 % vs. 16%, p = 0.026), all-cause mortality (10 % vs. 18%, p = 0.018), and incidence of hospital stays for HF (p = 0.033). In addition, a significant improvement of NYHA class was found in the CoQ10 group after 2 years (p = 0.028).

CONCLUSIONS:
Long-term CoQ10 treatment of patients with chronic HF is safe, improves symptoms, and reduces major adverse cardiovascular events.
(Coenzyme Q10 as adjunctive treatment of chronic heart failure: a randomized, double-blind, multi-center trial with focus on SYMptoms, BIomarker status [Brain-Natriuretic Peptide (BNP)], and long-term Outcome [hospitalisations/mortality]; ISRCTN94506234).

PMID: 25282031