Cited by 537Coenzyme Q10 studies and effectsLipoproteins and Cardiovascular HealthMuscle Physiology and Disorders

The Role of Coenzyme Q10 in Statin-Associated Myopathy

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Marcoff, Leo, Thompson, Paul D.·2007·Journal of the American College of Cardiology

Abstract

Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are currently the most effective medications for reducing low-density lipoprotein cholesterol concentrations. Although generally safe, they have been associated with a variety of myopathic complaints. Statins block production of farnesyl pyrophosphate, an intermediate in the synthesis of ubiquinone or coenzyme Q10 (CoQ10). This fact, plus the role of CoQ10 in mitochondrial energy production, has prompted the hypothesis that statin-induced CoQ10 deficiency is involved in the pathogenesis of statin myopathy. We identified English language articles relating statin treatment and CoQ10 levels via a PubMed search through August 2006. Abstracts were reviewed and articles addressing the relationship between statin treatment and CoQ10 levels were examined in detail. Statin treatment reduces circulating levels of CoQ10. The effect of statin therapy on intramuscular levels of CoQ10 is not clear, and data on intramuscular CoQ10 levels in symptomatic patients with statin-associated myopathy are scarce. Mitochondrial function may be impaired by statin therapy, and this effect may be exacerbated by exercise. Supplementation can raise the circulating levels of CoQ10, but data on the effect of CoQ10 supplementation on myopathic symptoms are scarce and contradictory. We conclude that there is insufficient evidence to prove the etiologic role of CoQ10 deficiency in statin-associated myopathy and that large, well-designed clinical trials are required to address this issue. The routine use of CoQ10 cannot be recommended in statin-treated patients. Nevertheless, there are no known risks to this supplement and there is some anecdotal and preliminary trial evidence of its effectiveness. Consequently, CoQ10 can be tested in patients requiring statin treatment, who develop statin myalgia, and who cannot be satisfactorily treated with other agents. Some patients may respond, if only via a placebo effect.

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Crossref · 10.1016/j.jacc.2007.02.049

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  1. Kelly P, Vasu S, Getato M, McNurlan M, Lawson WE. Coenzyme Q10 improves myopathic pain in statin treated patients (abstr). J Am Coll Cardiol 2005;45:3A.

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Authors
Marcoff, L., & Thompson, P. D.
Affiliations
  • Yale University (US)
  • Hartford Hospital (US)
Corresponding author
Thompson, Paul D.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2007-06
Volume
49
Issue
23
Pages
2231-2237
ISSN
0735-1097 (ISSN-L)
OpenAlex
W1701273068
Cited by
537
References
48
Citations by year
2026: 10 · 2025: 15 · 2024: 27 · 2023: 22 · 2022: 10 · 2021: 22 · 2020: 18 · 2019: 18 · 2018: 29 · 2017: 27 · 2016: 28 · 2015: 39 · 2014: 47 · 2013: 32 · 2012: 32
FWCI
2.92
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Coenzyme Q10 studies and effects
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
Keywords
coenzyme Q10, statin-induced myopathy, statins, ubiquinone deficiency, farnesyl pyrophosphate, mitochondrial function, coenzyme Q10 supplementation
MeSH terms
Coenzymes, Humans, Mitochondria, Cardiomyopathies, Ubiquinone, Muscle, Skeletal, Hydroxymethylglutaryl-CoA Reductase Inhibitors

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