title: Coenzyme Q10, rosuvastatin, and clinical outcomes in heart failure: a pre-specified substudy of CORONA (controlled rosuvastatin multinational study in heart failure).
abstract: OBJECTIVE
  The purpose of this study was to determine whether coenzyme Q₁₀ is an independent predictor of prognosis in heart failure.
  
  
  BACKGROUND
  Blood and tissue concentrations of the essential cofactor coenzyme Q₁₀ are decreased by statins, and this could be harmful in patients with heart failure.
  
  
  METHODS
  We measured serum coenzyme Q₁₀ in 1,191 patients with ischemic systolic heart failure enrolled in CORONA (Controlled Rosuvastatin Multinational Study in Heart Failure) and related this to clinical outcomes.
  
  
  RESULTS
  Patients with lower coenzyme Q₁₀ concentrations were older and had more advanced heart failure. Mortality was significantly higher among patients in the lowest compared to the highest coenzyme Q₁₀ tertile in a univariate analysis (hazard ratio: 1.50, 95% confidence interval: 1.04 to 2.6, p = 0.03) but not in a multivariable analysis. Coenzyme Q₁₀ was not an independent predictor of any other clinical outcome. Rosuvastatin reduced coenzyme Q₁₀ but there was no interaction between coenzyme Q₁₀ and the effect of rosuvastatin.
  
  
  CONCLUSIONS
  Coenzyme Q₁₀ is not an independent prognostic variable in heart failure. Rosuvastatin reduced coenzyme Q₁₀, but even in patients with a low baseline coenzyme Q₁₀, rosuvastatin treatment was not associated with a significantly worse outcome. (Controlled Rosuvastatin Multinational Study in Heart Failure [CORONA]; NCT00206310).
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow, United Kingdom. john.mcmurray@glasgow.ac.uk
authors.forename: John J V
authors.initials: JJ
authors.lastname: McMurray
authors.forename: Peter
authors.initials: P
authors.lastname: Dunselman
authors.forename: Hans
authors.initials: H
authors.lastname: Wedel
authors.forename: John G F
authors.initials: JG
authors.lastname: Cleland
authors.forename: Magnus
authors.initials: M
authors.lastname: Lindberg
authors.forename: Ake
authors.initials: A
authors.lastname: Hjalmarson
authors.forename: John
authors.initials: J
authors.lastname: Kjekshus
authors.forename: Finn
authors.initials: F
authors.lastname: Waagstein
authors.forename: Eduard
authors.initials: E
authors.lastname: Apetrei
authors.forename: Vivencio
authors.initials: V
authors.lastname: Barrios
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.forename: Gabriel
authors.initials: G
authors.lastname: Kamenský
authors.forename: Michel
authors.initials: M
authors.lastname: Komajda
authors.forename: Vyacheslav
authors.initials: V
authors.lastname: Mareev
authors.forename: John
authors.initials: J
authors.lastname: Wikstrand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005464:Fluorobenzenes / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D006760:Hospitalization / Q000639:trends; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D038622:Internationality; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors / Q000097:blood
chemical_list: D015415:Biomarkers; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D014451:Ubiquinone; D000068718:Rosuvastatin Calcium; C024989:coenzyme Q10