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The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial.
Copenhagen University Hospital, Copenhagen, Denmark.
Alfred Hospital, Monash University, Melbourne, Australia.
Government Medical College/G.N.D. Hospital, Amritsar, India.
Medical University of Vienna, Vienna, Austria.
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2014 (English)In: JACC. Heart failure, ISSN 2213-1787, Vol. 2, no 6, 641-649 p.Article in journal (Refereed) Published
Abstract [en]

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).

Place, publisher, year, edition, pages
2014. Vol. 2, no 6, 641-649 p.
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:liu:diva-113919DOI: 10.1016/j.jchf.2014.06.008ISI: 000365649100015PubMedID: 25282031OAI: diva2:785636
Available from: 2015-02-03 Created: 2015-02-03 Last updated: 2016-01-09

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Alehagen, Urban
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Division of Cardiovascular MedicineFaculty of Health SciencesDepartment of Cardiology in Linköping
Cardiac and Cardiovascular Systems

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