PMID 25282031 The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial Randomized controlled trial (Q-SYMBIO) · JACC Heart Fail, 2014 420 HF patients, 2 years - adding CoQ10 (300 mg/day) significantly lowered major cardiovascular events (15% vs 26%, HR 0.50), death, and hospitalization; short-term 16-week measures unchanged.
Key summary
A multicenter randomized double-blind trial evaluating CoQ10 as adjunctive therapy in 420 patients with moderate-to-severe chronic heart failureA condition in which the heart cannot pump enough blood to meet the body's needs.. On top of standard therapy, they received CoQ10 100 mg three times daily or placeboAn inert dummy treatment used as the comparison baseline. for 2 years. Short-term 16-week measures (NYHAA classification (New York Heart Association) grading heart-failure severity from class 1 to 4 by symptoms., 6-minute walk, NT-proBNP) did not change significantly, but the 2-year primary endpoint of major cardiovascular events was significantly lower with CoQ10 (15% vs 26%; hazard ratio 0.50, 95% CI 0.32 to 0.80, p=0.003). Cardiovascular mortality (9% vs 16%, p=0.026), all-cause mortality (10% vs 18%, p=0.018), and heart-failure hospitalization (p=0.033) were also lower, and NYHA class improved. It was the first adequately powered trial to show a long-term prognostic benefit of CoQ10 in heart failure.
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OBJECTIVES: This randomized controlled multicenter trial evaluated coenzyme Q10 (CoQ10) as adjunctive treatment in chronic heart failure (HF). BACKGROUND: CoQ10 is an essential cofactor for energy production and is also a powerful antioxidant. A low level of myocardial CoQ10 is related to the severity of HF. Previous randomized controlled trials of CoQ10 in HF were underpowered to address major clinical endpoints. METHODS: Patients with moderate to severe HF were randomly assigned in a 2-year prospective trial to either CoQ10 100 mg 3 times daily or placebo, in addition to standard therapy. The primary short-term endpoints at 16 weeks were changes in New York Heart Association (NYHA) functional classification, 6-min walk test, and levels of N-terminal pro-B type natriuretic peptide. The primary long-term endpoint at 2 years was composite major adverse cardiovascular events as determined by a time to first event analysis. RESULTS: A total of 420 patients were enrolled. There were no significant changes in short-term endpoints. The primary long-term endpoint was reached by 15% of the patients in the CoQ10 group versus 26% in the placebo group (hazard ratio: 0.50; 95% confidence interval: 0.32 to 0.80; p = 0.003) by intention-to-treat analysis. The following secondary endpoints were significantly lower in the CoQ10 group compared with the placebo group: cardiovascular mortality (9% vs. 16%, p = 0.026), all-cause mortality (10% vs. 18%, p = 0.018), and incidence of hospital stays for HF (p = 0.033). ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 35608922 Coenzyme Q10 for heart failure Meta-analysis (Cochrane) · Cochrane Database Syst Rev, 2021 11 studies, 1,573 people - CoQ10 probably reduces all-cause mortality (RR 0.58) and HF hospitalization (RR 0.62) (moderate quality), but the mortality benefit rests essentially on the single Q-SYMBIO trial with risk of bias in many studies.
Key summary
The 2021 updated CochraneAn international network that rigorously reviews and synthesizes evidence. review of CoQ10's safety and efficacy in heart failureA condition in which the heart cannot pump enough blood to meet the body's needs. (11 studies, 1,573 people). CoQ10 was judged to probably reduce all-cause mortality (risk ratio 0.58, 95% CI 0.35 to 0.95, moderate quality, number needed to treat 13.3) and to reduce heart-failure hospitalization (risk ratio 0.62, moderate quality). Left ventricular ejection fraction may improve but at very low quality, and exercise capacity was inconclusive. Importantly, the mortality benefit came from one trial (420 people, essentially Q-SYMBIO), most included studies had unclear or high risk of bias, and samples were small. The cautious conclusion is that CoQ10, though not a primary recommended therapy, could be beneficial as an add-on for people with heart failure.
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BACKGROUND: Coenzyme Q10, or ubiquinone, is a non-prescription nutritional supplement. Coenzyme Q10 deficiency may be associated with a multitude of diseases, including heart failure. OBJECTIVES: To review the safety and efficacy of coenzyme Q10 in heart failure. MAIN RESULTS: We included eleven studies, with 1573 participants, comparing coenzyme Q10 to placebo or conventional therapy (control). In the majority of the studies, sample size was relatively small. All studies had unclear, or high risk of bias, or both, in one or more bias domains. Coenzyme Q10 probably reduces the risk of all-cause mortality more than control (RR 0.58, 95% CI 0.35 to 0.95; 1 study, 420 participants; number needed to treat for an additional beneficial outcome (NNTB) 13.3; moderate-quality evidence). There was low-quality evidence of inconclusive results between the coenzyme Q10 and control groups for the risk of myocardial infarction (RR 1.62, 95% CI 0.27 to 9.59; 1 study, 420 participants), and stroke (RR 0.18, 95% CI 0.02 to 1.48; 1 study, 420 participants). Coenzyme Q10 probably reduces hospitalisation related to heart failure (RR 0.62, 95% CI 0.49 to 0.78; 2 studies, 1061 participants; NNTB 9.7; moderate-quality evidence). Very low-quality evidence suggests that coenzyme Q10 may improve the left ventricular ejection fraction (MD 1.77, 95% CI 0.09 to 3.44; 7 studies, 650 participants), but the results are inconclusive for exercise capacity. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 33999383 Effects of coenzyme Q10 supplementation on statin-induced myopathy: a meta-analysis of randomized controlled trials Meta-analysis · Ir J Med Sci, 2022 8 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 472 people - adding CoQ10 improved neither muscle enzyme (CK, p=0.84) nor muscle pain (p=0.22) vs placeboAn inert dummy treatment used as the comparison baseline.. Rebuts the 'CoQ10 for statinA common lipid-lowering drug that reduces LDL cholesterol. muscle pain' belief.
Key summary
A meta-analysisA statistical synthesis combining results of multiple studies into one conclusion. of whether adding CoQ10 helps statinA common lipid-lowering drug that reduces LDL cholesterol.-induced myopathy, pooling eight randomized controlled trialA high-reliability trial randomly assigning participants to compare effects (RCT).s (472 people) in statin-treated patients. Adding CoQ10 did not significantly change the muscle-damage marker creatine kinase (CK) (mean difference 3.29 U/L, 95% CI -29.58 to 36.17, p=0.84) and did not improve muscle pain versus placeboAn inert dummy treatment used as the comparison baseline. (standardized mean difference -0.59, 95% CI -1.54 to 0.36, p=0.22). The authors concluded that CoQ10 supplementation had no significant benefit for statin-induced myopathy, confirming that although the practice is widespread, the clinical evidence is scant.
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BACKGROUND: Statins can trigger a series of muscle-related adverse events, commonly referred to collectively as statin-induced myopathy. Although coenzyme Q10 (CoQ10) is widely used as a supplement in statin therapy, there is little clinical evidence for this practice. AIM: This study aims to assess the effect of adding CoQ10 on statin-induced myopathy. METHODS: Searching the PubMed, EMBASE, and the Cochrane Library databases to identify randomized controlled trials investigating the effect of adding CoQ10 on creatine kinase (CK) activity and degree of muscle pain as two indicators of statin-induced myopathy. RESULTS: We had a total of 8 studies in which 472 patients were treated with statins: 6 studies with 281 participants assessed the impact of adding CoQ10 on CK activity, and 4 studies with 220 participants were included to evaluate the impacts of CoQ10 addition on muscle pain. Compared with the controls, CK activity increased after adding CoQ10, but the change was not significant (mean difference, 3.29 U/L; 95% CI, - 29.58 to 36.17 U/L; P = 0.84). Similarly, the meta-analysis did not benefit CoQ10 over placebo in improving muscle pain (standardized mean difference, - 0.59; 95% CI, - 1.54 to 0.36; P = 0.22). CONCLUSION: The outcomes of this meta-analysis of existing randomized controlled trials showed that supplementation with CoQ10 did not have any significant benefit in improving statin-induced myopathy. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 26935713 Blood pressure lowering efficacy of coenzyme Q10 for primary hypertension Meta-analysis (Cochrane) · Cochrane Database Syst Rev, 2016 CochraneAn international network that rigorously reviews and synthesizes evidence. (2 RCTRandomized controlled trial - a high-reliability trial that randomly assigns participants to compare effects.s, 50 people) - CoQ10 did not significantly lower systolic (-3.68) or diastolic (-2.03) BP. 'No clinically significant effect on blood pressure' (moderate quality).
Key summary
A CochraneAn international network that rigorously reviews and synthesizes evidence. review (2016 update) of CoQ10's blood-pressure-lowering effect in primary hypertension. The 2009 first edition called the evidence uncertain, and the update stayed negative. Pooling two of three double-blind placeboAn inert dummy treatment used as the comparison baseline.-controlled trials (50 people; one was excluded for unacceptably high risk of bias), CoQ10 did not significantly lower systolic (-3.68 mmHg, 95% CI -8.86 to 1.49) or diastolic blood pressure (-2.03 mmHg, 95% CI -4.86 to 0.81). The authors concluded there was moderate-quality evidence that CoQ10 has no clinically significant effect on blood pressure, while noting the small number of studies and participants means more trials are needed.
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BACKGROUND: Clinical trials have suggested that coenzyme Q10, a non-prescription nutritional supplement, can effectively lower blood pressure (BP). When this review was completed and published in October 2009, it concluded that "due to the possible unreliability of the 3 included studies, it is uncertain whether or not coenzyme Q10 reduces blood pressure in the long-term management of primary hypertension." OBJECTIVES: To determine the blood pressure lowering effect of coenzyme Q10 in primary hypertension. MAIN RESULTS: In this update of the review, one new randomized, controlled cross-over trial with a total of 30 participants was added, and one trial included in the initial review was excluded. Only two of the three included trials were pooled in the meta-analysis, as one trial was judged to have an unacceptably high risk of bias. In the meta-analysis of two RCTs (50 participants), coenzyme Q10 did not significantly change systolic BP: -3.68 mm Hg (95% confidence interval (CI) -8.86 to 1.49), or diastolic BP: -2.03 mm Hg (95% CI -4.86 to 0.81), based on clinic data. AUTHORS' CONCLUSIONS: This review provides moderate-quality evidence that coenzyme Q10 does not have a clinically significant effect on blood pressure. In one of three trials reporting adverse effects, coenzyme Q10 was well tolerated. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
View original ↗ PMID 32698345 Effect of Supplements on Endurance Exercise in the Older Population: Systematic Review Systematic review · Int J Environ Res Public Health, 2020 Review of supplements for endurance exercise in older adults - caffeine and protein+beta-alanine helped, but ubiquinoneAnother name for coenzyme Q10; a fat-soluble molecule involved in energy (ATP) production in mitochondria. (CoQ10) showed no confirmed benefit for endurance in older men.
Key summary
A systematic review (eight studies) of nutritional strategies for endurance exercise in older adults. Caffeine and protein plus beta-alanine helped in both sexes, and in older women a balanced diet, more protein, and sodium bicarbonate were favorable. By contrast, in older men no benefit was seen from sodium bicarbonate or ubiquinoneAnother name for coenzyme Q10; a fat-soluble molecule involved in energy (ATP) production in mitochondria. (coenzyme Q10). It illustrates the lack of support for using CoQ10 for 'energy and performance,' and the authors noted supplements should be used cautiously according to individual characteristics and activity.
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BACKGROUND: Ageing is associated with changes of physical and physiological parameters, but there is evidence that regular physical activity could minimize these effects. Additionally, the older population presents a great risk of suboptimal nutrition. Therefore, the purpose of this study was to review the evidence of nutritional strategies and endurance exercises in the older population. METHODS: A systematic review was performed based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. RESULTS: Eight studies were included in the present review. The use of caffeine and beta-alanine supplementation with proteins have been found to be beneficial in both sexes. In older women, a balanced diet, an increase in protein, supplementation with beta hydroxy methyl butyrate, and supplementation with sodium bicarbonate have been favorable. However, no benefit has been seen in older men with sodium bicarbonate or ubiquinone supplementation. Nevertheless, the use of supplements should be prescribed according to individual characteristics and physical activity. CONCLUSIONS: Caffeine and high protein supplement with beta-alanine may provide positive effects in the older population. ※ The abstract text as collected and stored via the API by the pipeline. The key summary is written based solely on this text.
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