title: Coenzyme Q10 and Heart Failure: A State-of-the-Art Review.
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.affiliation: 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.).
authors.forename: Abhinav
authors.initials: A
authors.lastname: Sharma
authors.affiliation: 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.).
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: 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.).
authors.forename: Javed
authors.initials: J
authors.lastname: Butler
authors.affiliation: 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.).
authors.forename: Justin A
authors.initials: JA
authors.lastname: Ezekowitz
authors.affiliation: 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.
authors.forename: G Michael
authors.initials: GM
authors.lastname: Felker
mesh_terms: D000818:Animals; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019587:Dietary Supplements / Q000009:adverse effects; D004347:Drug Interactions; D004734:Energy Metabolism / Q000187:drug effects; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D006801:Humans; D008929:Mitochondria, Heart / Q000187:drug effects / Q000201:enzymology; D009206:Myocardium / Q000201:enzymology*; D016896:Treatment Outcome; D014451:Ubiquinone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D002317:Cardiovascular Agents; D014451:Ubiquinone; C024989:coenzyme Q10
keywords: coenzyme Q10; drug interactions; electrolytes; heart failure; hypotension