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Q-SYMBIO: Coenzyme Q10 reduced major CV events in patients with HF
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Confirming previous findings, coenzyme Q10 was associated with a lower rate of major adverse CV events in patients with HF, researchers reported in JACC: Heart Failure.
Svend A. Mortensen, MD, DSc, and colleagues enrolled 420 patients with HF regardless of left ventricular ejection fraction in the Q-SYMBIO study. Although previous research had shown that low levels of myocardial coenzyme Q10 (CoQ10) is related to the severity of HF, previous trials of CoQ10 supplementation were underpowered to address major clinical endpoints, according to the study background.
Patients received standard therapy and were randomly assigned CoQ10 100 mg or placebo three times daily. The primary long-term endpoint was a composite of major adverse CV events, defined as unplanned hospitalization for worsening HF, CV death, mechanical assist implantation or urgent cardiac transplantation, at 2 years.
At 2 years, 15% of the CoQ10 group reached the primary endpoint vs. 26% of controls (HR=0.5; 95% CI, 0.32-0.8). Compared with controls, at 2 years the CoQ10 group had lower rates of CV mortality (9% vs. 16%; P=.026), all-cause mortality (10% vs. 18%; P=.018) and incidence of HF hospitalization (P=.033). The CoQ10 group also had significant improvement in NYHA class compared with controls (P=.028). The researchers found no significant differences between the groups in short-term endpoints of change in NYHA classification, 6-minute walk distance and levels of N-terminal pro–B type natriuretic peptide at 16 weeks.
Adverse events were slightly lower in the CoQ10 group compared with controls (13% vs. 19%; P=.11).
“CoQ10 treatment may impede the vicious metabolic cycle in HF, via a favorable alteration in redox signaling in the mitochondria that leads to increased energy production in the failing heart,” Mortensen, from the department of cardiology, Heart Centre, Copenhagen University Hospital, and colleagues wrote. “In addition, CoQ10 therapy may lead to increased stabilization of the mitochondrial permeability transition pore and may shield the myocardium against apoptotic cell loss. Furthermore, it has been shown that CoQ10 may improve endothelial function, and it may protect the myocardium against ischemia.”
The researchers presented preliminary results at Heart Failure Congress 2013.
Disclosure: The study was supported by International Coenzyme Q10 Association, Pharma Nord ApS and Kaneka Corp. The researchers report no relevant financial disclosures.
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