CoQ10 supplementation may offer clinical value for patients with heart failure, systematic review shows
- Data extracted from 7 systematic reviews, describing 71 RCTs
- Interventions compared CoQ10 vs. placebo
- All systematic reviews in patients with heart failure included
- Findings suggest CoQ10 may offer clinical value as adjunct therapy for patients with heart failure
This systematic review was designed to determine if coenzyme Q10 (CoQ10) supplementation has therapeutic value for patients with heart failure.
Study inclusion criteria was limited to systematic reviews (including meta-analyses) of controlled clinical trials published in the peer-reviewed literature up to May 16, 2017. Interventions compared CoQ10 supplementation to placebo. All systematic reviews that assessed the effects of CoQ10 supplementation in patients with heart failure were included. No language restriction was applied.
A total of 7 systematic reviews (2 Cochrane reviews and 5 non-Cochrane reviews) met the inclusion criteria, describing 71 different randomized controlled trials (RCTs).
No meta-analyses were performed due to the heterogeneity of studies, but key findings were provided, which are summarized below:
- Soja (1997). Meta-analysis of 8 randomized trials (356 patients) showing a significant improvement of SV, CO, EF, CI, and EDVI, suggesting CoQ10 offers value as an adjuvant treatment of CHF.
- Rosenfeldt (2003). Meta-analysis of 9 randomized trials (824 patients) showing a trend towards improved EF in patients with heart failure.
- Sander (2006). Meta-analysis of 11 trials (319 patients) showing significant changes in EF, CO, and SI.
- Fotino (2013). Meta-analysis of 13 trials (395 patients) indicating CoQ10 benefits may be limited to patients with less severe stages of CHF.
- Mamdani (2013). Meta-analysis of 7 trials (914 patients) showing no convincing evidence to support or refute the use of CoQ10 for heart failure.
- Flowers (2013). Meta-analysis of 7 trials (218 patients) producing insufficient data to draw any conclusions.
- Trongtorsak (2016). Meta-analysis of 16 trials (1,662 patients) supporting use of CoQ10 combined with standard therapy in HF to reduce mortality.
Legend: SV, stroke volume; CO, cardiac output; EF, ejection fraction; CI, cardiac index; CHF, chronic heart failure; SI, systolic index; HF, heart failure.
The authors note three different actions may play a role in the potential benefits of CoQ10 supplementation in patients with heart failure. First, CoQ10 increases adenosine triphosphate (ATP) generation and cellular energy by mediating electron transfer in the electron transport chain. Second, it reduces oxidative stress, a well-known marker of mortality in heart failure, and prevents membrane oxidation and lipid peroxidation. Third, CoQ10 stabilizes calcium-dependent ion channels in the myocardium thereby enhancing ATP synthesis.
Collectively, these findings suggest CoQ10 supplementation may offer clinical value as adjunct therapy for patients with heart failure.