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DRUG INFORMATION ROUNDS

The Role of Coenzyme Q₁₀ in Heart Failure

Critical Care Specialty Resident, University of Kentucky Chandler Medical Center, Lexington, KY

Kelly M Smith, PharmD

Associate Professor, Pharmacy Practice and Science; Director, Drug Information Center, College of Pharmacy, University of Kentucky

Reprints: Dr. Smith, University of Kentucky Chandler Medical Center, 800 Rose St., C113, Lexington, KY 40536-0293, fax 859/323-2049, ksmit1{at}email.uky.edu

OBJECTIVE: To review the clinical data demonstrating the safety and efficacy of coenzyme Q₁₀ (CoQ₁₀) in heart failure (HF).

DATA SOURCES: Pertinent literature was identified through MEDLINE (1966–January 2005) using the search terms coenzyme Q₁₀, heart failure, antioxidants, and oxidative stress. Only articles written in the English language and evaluating human subjects were used.

DATA SYNTHESIS: HF impairs the ability of the heart to maintain its normal cardiac output. Following an initial insult, cardiac remodeling ensues, resulting in left ventricular dilation and hypertrophy. Oxidative stress is also increased, while CoQ₁₀ levels are decreased in patients with HF. This has led to the hypothesis that CoQ₁₀, an antioxidant, may decrease oxidative stress, impair remodeling, and improve cardiac function.

CONCLUSIONS: Large, well-designed studies on this topic are lacking. The limited data from well-designed trials indicate there may be some minor benefits with CoQ₁₀ therapy in ejection fraction and end diastolic volume. CoQ₁₀ therapy has been shown to be relatively safe with a low incidence of adverse effects.

Key Words: coenzyme Q₁₀, heart failure, oxidative stress

Published Online, July 26, 2005. www.theannals.com, DOI 10.1345/aph.1E554

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