title: Rosuvastatin combined with regular exercise preserves coenzyme Q10 levels associated with a significant increase in high-density lipoprotein cholesterol in patients with coronary artery disease.
abstract: BACKGROUND
  Coenzyme Q10 levels are low in patients with coronary artery disease (CAD), and increasing or preserving coenzyme Q10 could be a beneficial strategy. Exercise and statins improve high-density lipoprotein cholesterol (HDL-C) levels. However, statins inhibit coenzyme Q10 biosynthesis, and the combination of statins with coenzyme Q10 supplementation increases HDL-C compared to statins alone. We compared the effects of two statins (rosuvastatin and atorvastatin) combined with exercise on coenzyme Q10 and HDL-C levels in CAD patients.
  
  
  METHODS
  After randomizing 28 CAD patients to rosuvastatin (n=14) and atorvastatin (n=14) groups, patients performed weekly in-hospital aerobic exercise and daily home exercise for 20 weeks. We measured serum lipids, ubiquinol, and exercise capacity.
  
  
  RESULTS
  Both statins equally improved exercise capacity and lowered low-density lipoprotein cholesterol and triglyceride levels. Rosuvastatin significantly increased HDL-C (rosuvastatin, +12 ± 9 mg/dL [+30%], atorvastatin, +5 ± 5 mg/dL [+13%], p=0.014) and apolipoprotein A1 (ApoA1) (rosuvastatin, +28.3 ± 20.7 mg/dL, atorvastatin, +13.4 ± 12.0 mg/dL, p=0.030) compared to atorvastatin. Atorvastatin significantly decreased serum ubiquinol (731 ± 238 to 547 ± 219 nmol/L, p=0.001), but rosuvastatin (680±233 to 668 ± 299 nmol/L, p=0.834) did not. There was a significant positive correlation between changes in ubiquinol and ApoA1 (r=0.518, p=0.005). Multivariate regression analysis showed that changes in ubiquinol correlated significantly with changes in ApoA1 after adjusting for age, sex, body mass index, and smoking (β=0.502, p=0.008).
  
  
  CONCLUSIONS
  Compared to atorvastatin, rosuvastatin combined with exercise significantly preserved ubiquinol levels associated with an increase in HDL-C. Rosuvastatin with regular exercise could be beneficial for CAD patients.
authors: Department of Cardiovascular Medicine, Faculty of Life Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors: Kensuke
authors: K
authors: Toyama
authors: Seigo
authors: S
authors: Sugiyama
authors: Hideki
authors: H
authors: Oka
authors: Yuri
authors: Y
authors: Iwasaki
authors: Hitoshi
authors: H
authors: Sumida
authors: Tomoko
authors: T
authors: Tanaka
authors: Shinji
authors: S
authors: Tayama
authors: Hideaki
authors: H
authors: Jinnouchi
authors: Kunihiko
authors: K
authors: Matsui
authors: Hisao
authors: H
authors: Ogawa
mesh_terms: D000368:Aged; D000069059:Atorvastatin; D008076:Cholesterol, HDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood* / Q000188:drug therapy*; D004452:Echocardiography / Q000379:methods; D015444:Exercise; D005260:Female; D005464:Fluorobenzenes / Q000494:pharmacology*; D006538:Heptanoic Acids / Q000494:pharmacology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011743:Pyrimidines / Q000494:pharmacology*; D011758:Pyrroles / Q000494:pharmacology; D012306:Risk; D000068718:Rosuvastatin Calcium; D012907:Smoking; D013449:Sulfonamides / Q000494:pharmacology*; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000097:blood / Q000235:genetics / Q000494:pharmacology
chemical_list: D008076:Cholesterol, HDL; D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D014451:Ubiquinone; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin; C024989:coenzyme Q10; C003741:ubiquinol