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JACC Heart Fail. 2014 Dec;2(6):641-9. doi: 10.1016/j.jchf.2014.06.008. Epub 2014 Oct 1.

The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial.

Author information

1
Department of Cardiology, Heart Centre, Copenhagen University Hospital, Copenhagen, Denmark. Electronic address: doctormortensen@gmail.com.
2
Cardiac Surgical Research Unit, Alfred Hospital, Monash University, Melbourne, Australia.
3
Department of Cardiology, Government Medical College/G.N.D. Hospital, Amritsar, India.
4
Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
5
First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
6
Medical Faculty of P.J. Safarik University, Kosice, Slovakia.
7
University Hospital, Linköping, Sweden.
8
Clinical and Dental Sciences, Biochemistry Section, Polytechnic University of The Marche, Ancona, Italy.

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 randomised, double-blind, multicentre trial with focus on SYMptoms, BIomarker status [Brain-Natriuretic Peptide (BNP)], and long-term Outcome [hospitalisations/mortality]; ISRCTN94506234).

KEYWORDS:

chronic heart failure; coenzyme Q(10); metabolic therapy; randomized controlled trial; ubiquinone

PMID:
25282031
DOI:
10.1016/j.jchf.2014.06.008
[Indexed for MEDLINE]
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