Coenzyme Q10 for Patients With Cardiovascular Disease: JACC Focus Seminar

J Am Coll Cardiol. 2021 Feb 9;77(5):609-619. doi: 10.1016/j.jacc.2020.12.009.

Abstract

Coenzyme Q10 (CoQ10) is a naturally occurring compound that is found in animals and all humans. It has a fundamental role in cellular energy production. Although it is produced in the body, tissue deficiency can occur due to medications such as statins, which inhibit the mevalonate pathway. The clinical syndromes of statin-associated muscle symptoms (SAMS) and some of the features observed in patients with heart failure (HF) may be related to blood and tissue deficiency of CoQ10. Numerous clinical trials of CoQ10 in SAMS have yielded conflicting results. Yet, the weight of evidence as reflected in meta-analyses supports the use of exogenous CoQ10 in SAMS. In patients with HF, large-scale randomized clinical trials are lacking, although one relatively contemporary trial, Q-SYMBIO, suggests an adjunctive role for CoQ10. The possibility that statin-related CoQ10 deficiency may play a role in patients with diastolic HF is an intriguing hypothesis that warrants further exploration.

Keywords: CoQ(10); coenzyme Q(10); statin-associated cardiomyopathy; statin-associated muscle symptoms.

Publication types

  • Review

MeSH terms

  • Ataxia / drug therapy*
  • Cardiovascular Diseases / prevention & control*
  • Dietary Supplements
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Mitochondrial Diseases / drug therapy*
  • Muscle Weakness / drug therapy*
  • Ubiquinone / analogs & derivatives*
  • Ubiquinone / deficiency*
  • Ubiquinone / therapeutic use

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Ubiquinone
  • coenzyme Q10

Supplementary concepts

  • Coenzyme Q10 Deficiency