Could CoQ10 Benefit Heart Failure Patients?
AUGUST 09, 2016
Jeannette Y. Wick, RPh, MBA, FASCP
Heart failure (HF) affects 5.1 million individuals in the United States annually, and it’s one of the most frequent causes of hospitalizations.
Researchers have suggested that coenzyme Q10 (CoQ10) may be beneficial in HF patients by exerting 3 different mechanisms: increasing ATP generation and cellular energy, reducing oxidative stress, and stabilizing calcium-dependent ion channels in the myocardium.
The topic was reviewed in a new article that appeared in the August 2016 issue of Current Heart Failure Reports. Prepared by 2 researchers from Ochsner Clinical School-University of
Queensland School of Medicine in New Orleans, the research indicated that CoQ10’s clinical utility is growing.
Several randomized, controlled trials [RCTs] have examined CoQ10 supplementation. The largest demonstrated that NYHA class III or IV HF patients had 50% fewer hospitalizations but no mortality benefit. However, other smaller trials haven’t shown benefit in cardiac function or exercise tolerance.
Three meta-analyses addressed some of the issues that the RCTs brought to light. They suggested that CoQ10 benefits hemodynamic parameters, but mortality benefit remains unclear.
Although CoQ10 appears to be safe, the American College of Cardiology and American Heart Association didn’t include it in their 2013 HF guidelines.
Recent results from the Q-SYMBIO trial demonstrated that CoQ10 supplementation improves HF symptoms with a significant reduction in major adverse cardiovascular events and mortality. However, these results were only seen after long-term supplementation (longer than 106 weeks).
CoQ10 is fat soluble and more than 50% is excreted, which may be a barrier to achieving therapeutic levels. In addition, some HF patients have a difficult time absorbing CoQ10 because of intestinal edema and congestion. Clinicians can circumvent this problem by prescribing divided daily dosing of CoQ10 to ensure adequate absorption.
Although the ACC and AHA didn’t include CoQ10 in their 2013 guidelines, the supplement has shown benefits in several RCTs and meta-analyses. The recent Q-SYMBIO trial demonstrated that supplemental CoQ10 may be a management option for HF patients.