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Coenzyme Q10 and Heart Failure: A State-of-the-Art Review.
Circ Heart Fail 2016; 9(4):e002639CH

Abstract

Heart failure (HF) with either preserved or reduced ejection fraction is associated with increased morbidity and mortality. Evidence-based therapies are often limited by tolerability, hypotension, electrolyte disturbances, and renal dysfunction. Coenzyme Q10 (CoQ10) may represent a safe therapeutic option for patients with HF. CoQ10 is a highly lipophilic molecule with a chemical structure similar to vitamin K. Although being a common component of cellular membranes, CoQ10's most prominent role is to facilitate the production of adenosine triphosphate in the mitochondria by participating in redox reactions within the electron transport chain. Numerous trials during the past 30 years examining CoQ10 in patients with HF have been limited by small numbers and lack of contemporary HF therapies. The recent publication of the Q-SYMBIO randomized controlled trial demonstrated a reduction in major adverse cardiovascular events with CoQ10 supplementation in a contemporary HF population. Although having limitations, this study has renewed interest in evaluating CoQ10 supplementation in patients with HF. Current literature suggests that CoQ10 is relatively safe with few drug interactions and side effects. Furthermore, it is already widely available as an over-the-counter supplement. These findings warrant future adequately powered randomized controlled trials of CoQ10 supplementation in patients with HF. This state-of-the-art review summarizes the literature about the mechanisms, clinical data, and safety profile of CoQ10 supplementation in patients with HF.

Authors+Show Affiliations

From the Division of Cardiology, Duke University School of Medicine, Duke Heart Center, Durham, NC (A.S., G.M.F.); Division of Cardiology, Canadian VIGOUR Centre, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton (A.S., J.A.E.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center (G.C.F.); and Department of Medicine, Division of Cardiology, Stony Brook University, NY (J.B.).From the Division of Cardiology, Duke University School of Medicine, Duke Heart Center, Durham, NC (A.S., G.M.F.); Division of Cardiology, Canadian VIGOUR Centre, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton (A.S., J.A.E.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center (G.C.F.); and Department of Medicine, Division of Cardiology, Stony Brook University, NY (J.B.).From the Division of Cardiology, Duke University School of Medicine, Duke Heart Center, Durham, NC (A.S., G.M.F.); Division of Cardiology, Canadian VIGOUR Centre, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton (A.S., J.A.E.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center (G.C.F.); and Department of Medicine, Division of Cardiology, Stony Brook University, NY (J.B.).From the Division of Cardiology, Duke University School of Medicine, Duke Heart Center, Durham, NC (A.S., G.M.F.); Division of Cardiology, Canadian VIGOUR Centre, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton (A.S., J.A.E.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center (G.C.F.); and Department of Medicine, Division of Cardiology, Stony Brook University, NY (J.B.).From the Division of Cardiology, Duke University School of Medicine, Duke Heart Center, Durham, NC (A.S., G.M.F.); Division of Cardiology, Canadian VIGOUR Centre, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton (A.S., J.A.E.); Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan UCLA Medical Center (G.C.F.); and Department of Medicine, Division of Cardiology, Stony Brook University, NY (J.B.). michael.felker@duke.edu.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

27012265

Citation

Sharma, Abhinav, et al. "Coenzyme Q10 and Heart Failure: a State-of-the-Art Review." Circulation. Heart Failure, vol. 9, no. 4, 2016, pp. e002639.
Sharma A, Fonarow GC, Butler J, et al. Coenzyme Q10 and Heart Failure: A State-of-the-Art Review. Circ Heart Fail. 2016;9(4):e002639.
Sharma, A., Fonarow, G. C., Butler, J., Ezekowitz, J. A., & Felker, G. M. (2016). Coenzyme Q10 and Heart Failure: A State-of-the-Art Review. Circulation. Heart Failure, 9(4), pp. e002639. doi:10.1161/CIRCHEARTFAILURE.115.002639.
Sharma A, et al. Coenzyme Q10 and Heart Failure: a State-of-the-Art Review. Circ Heart Fail. 2016;9(4):e002639. PubMed PMID: 27012265.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coenzyme Q10 and Heart Failure: A State-of-the-Art Review. AU - Sharma,Abhinav, AU - Fonarow,Gregg C, AU - Butler,Javed, AU - Ezekowitz,Justin A, AU - Felker,G Michael, PY - 2015/09/03/received PY - 2015/12/22/accepted PY - 2016/3/26/entrez PY - 2016/3/26/pubmed PY - 2016/8/2/medline KW - coenzyme Q10 KW - drug interactions KW - electrolytes KW - heart failure KW - hypotension SP - e002639 EP - e002639 JF - Circulation. Heart failure JO - Circ Heart Fail VL - 9 IS - 4 N2 - Heart failure (HF) with either preserved or reduced ejection fraction is associated with increased morbidity and mortality. Evidence-based therapies are often limited by tolerability, hypotension, electrolyte disturbances, and renal dysfunction. Coenzyme Q10 (CoQ10) may represent a safe therapeutic option for patients with HF. CoQ10 is a highly lipophilic molecule with a chemical structure similar to vitamin K. Although being a common component of cellular membranes, CoQ10's most prominent role is to facilitate the production of adenosine triphosphate in the mitochondria by participating in redox reactions within the electron transport chain. Numerous trials during the past 30 years examining CoQ10 in patients with HF have been limited by small numbers and lack of contemporary HF therapies. The recent publication of the Q-SYMBIO randomized controlled trial demonstrated a reduction in major adverse cardiovascular events with CoQ10 supplementation in a contemporary HF population. Although having limitations, this study has renewed interest in evaluating CoQ10 supplementation in patients with HF. Current literature suggests that CoQ10 is relatively safe with few drug interactions and side effects. Furthermore, it is already widely available as an over-the-counter supplement. These findings warrant future adequately powered randomized controlled trials of CoQ10 supplementation in patients with HF. This state-of-the-art review summarizes the literature about the mechanisms, clinical data, and safety profile of CoQ10 supplementation in patients with HF. SN - 1941-3297 UR - https://www.unboundmedicine.com/medline/citation/27012265/Coenzyme_Q10_and_Heart_Failure:_A_State_of_the_Art_Review_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCHEARTFAILURE.115.002639?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -