Washington: A food supplement named Coenzyme Q10 can decrease death because of heart failure by half, according to the results of a trial.
According to lead author Professor Svend Aage Mortensen, it is the first drug to improve heart failure mortality in over a decade and should be added to standard treatment.
Coenzyme Q10 (CoQ10) occurs naturally in the body and is essential to survival. CoQ10 works as an electron carrier in the mitochondria, the powerhouse of the cells, to produce energy and is also a powerful antioxidant. It is the only antioxidant that humans synthesise in the body.
The Q-SYMBIO study (2) randomised 420 patients with severe heart failure (New York Heart Association (NYHA) Class III or IV) to CoQ10 or placebo and followed them for 2 years.
The primary endpoint was time to first major adverse cardiovascular event (MACE) which included unplanned hospitalisation due to worsening of heart failure, cardiovascular death, urgent cardiac transplantation and mechanical circulatory support. Participating centres were in Denmark, Sweden, Austria, Slovakia, Poland, Hungary, India, Malaysia and Australia.
CoQ10 halved the risk of MACE , with 29 (14 percent) patients in the CoQ10 group reaching the primary endpoint compared to 55 (25 percent) patients in the placebo group (hazard ratio=2; p=0.003).
CoQ10 also halved the risk of dying from all causes, which occurred in 18 (9 percent) patients in the CoQ10 group compared to 36 (17 percent) patients in the placebo group (hazard ratio=2.1; p=0.01).
CoQ10 treated patients had significantly lower cardiovascular mortality (p=0.02) and lower occurrence of hospitalisations for heart failure (p=0.05). There were fewer adverse events in the CoQ10 group compared to the placebo group (p=0.073).
CoQ10 is present in food, including red meat, plants and fish, but levels are insufficient to impact on heart failure. CoQ10 is also sold over the counter as a food supplement but Mortensen said that food supplements can influence the effect of other medications including anticoagulants and patients should seek advice from their doctor before taking them.
Patients with ischaemic heart disease who use statins could also benefit from CoQ10 supplementation.
Mortensen said that they have no controlled trials demonstrating that statin therapy plus CoQ10 improves mortality more than statins alone. But statins reduce CoQ10, and circulating CoQ10 prevents the oxidation of LDL effectively, so I think ischaemic patients should supplement statin therapy with CoQ10.