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Cited by 488Coenzyme Q10 studies and effectsHeart Failure Treatment and ManagementCardiac Fibrosis and Remodeling

The Effect of Coenzyme Q 10 on Morbidity and Mortality in Chronic Heart Failure

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Mortensen, Svend A., Rosenfeldt, Franklin, Kumar, Adarsh, Dolliner, Peter, Filipiak, Krzysztof J., Pella, Daniel, Alehagen, Urban, Steurer, Günter +1 more·2014·JACC: Heart Failure
DOI 10.1016/j.jchf.2014.06.008
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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).

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Authors
Mortensen, S. A., Rosenfeldt, F., Kumar, A., Dolliner, P., Filipiak, K. J., Pella, D., Alehagen, U., Steurer, G., & Littarru, G. P.
Affiliations
  • Copenhagen University Hospital (DK)
  • The Alfred Hospital (AU)
  • Government Medical College, Amritsar (IN)
  • Medical University of Vienna (AT)
  • Medical University of Warsaw (PL)
  • University of Pavol Jozef Šafárik (SK)
  • Linköping University Hospital (SE)
  • Marche Polytechnic University (IT)
Corresponding author
Mortensen, Svend A.
ORCID
Venue
JACC: Heart Failure
Publisher
Elsevier BV
Published
2014-12
Volume
2
Issue
6
Pages
641-649
ISSN
2213-1779 (ISSN-L)
DOI
10.1016/j.jchf.2014.06.008
OpenAlex
W1657534147
Cited by
488
References
2
Citations by year
2026: 34 · 2025: 51 · 2024: 45 · 2023: 45 · 2022: 44 · 2021: 53 · 2020: 49 · 2019: 47 · 2018: 30 · 2017: 27 · 2016: 26 · 2015: 30 · 2014: 2 · 2013: 4
FWCI
11.62
Type
journal article
Language
en
Open access
Licence
Locations
  • JACC Heart Failure (publishedVersion)
  • PubMed (publishedVersion)
  • INFM-OAR (INFN Catania) (submittedVersion, other-oa)
Funders
  • International Coenzyme Q10 Association
  • Kaneka Corp.
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Coenzyme Q10 studies and effects
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
Keywords
coenzyme Q10, chronic heart failure, adjunctive therapy, major adverse cardiovascular events, cardiovascular mortality, all-cause mortality, hospitalization, NYHA functional class, natriuretic peptides, antioxidants, energy metabolism
MeSH terms
Chronic Disease, Double-Blind Method, Female, Heart Failure, Hospitalization, Humans, Male, Middle Aged, Peptide Fragments, Prospective Studies, Ubiquinone, Vitamins, Biomarkers, Death, Sudden, Cardiac, Natriuretic Peptide, Brain

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