Coenzyme Q10 following myocardial infarction

Townsend Letter for Doctors and Patients,  July, 2004  by Alan R. Gaby

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One hundred forty-four patients with acute myocardial infarction were randomly assigned to receive, in double-blind fashion, 60 mg of coenzyme Q10 (CoQ10) twice a day or "placebo" (B vitamins providing daily: thiamine 12 mg, riboflavin 12 mg, pyridoxine 4 mg, and niacinamide 100 mg) for one year. Treatment was begun within 72 hours of the onset of symptoms. Approximately half of the patients in each group were receiving lovastatin (10 mg/day). After one year, total cardiac events (24.6 vs. 45.0%; p < 0.02), including nonfatal infarction (13.7 vs. 25.3%; p < 0.05) and cardiac deaths were significantly lower in the CoQ10 group than in the control group. The mean plasma levels of vitamin E (32.4 vs. 22.1 micromol/L) and HDL cholesterol (1.26 vs. 1.12 mmol/L) were significantly higher (p < 0.05), whereas measures of oxidative stress (thiobarbituric acid reactive substances, malondialdehyde, and diene conjugates) were significantly lower, in the CoQ group compared with the placebo group. The prevalence of fatigue was 6.8% in the CoQ10 group and. 40.8% in the control group (p < 0.01).

Comment: A considerable body of evidence, some conflicting, indicates that CoQ10 is beneficial for the prevention and treatment of congestive heart failure. In contrast, the potential value of CoQ10 for secondary prevention of myocardial infarction has not been systematically studied. The results of the present study indicate that supplementation with coenzyme Q10 for one year after acute myocardial infarction significantly reduced cardiac deaths and recurrences of non-fatal myocardial infarction. In addition, CoQ10 therapy reduced signs of oxidative stress and decreased the prevalence of fatigue. In a previous study, supplementation with CoQ10 improved exercise tolerance in patients with coronary artery disease. Ironically, treatment with statin drugs, which are used to prevent heart disease, often reduces blood levels of CoQ10, by inhibiting its synthesis in the body. There is reason to believe that adding CoQ10 to statin therapy would both enhance the benefits and reduce the side effects of these drugs.

Singh RB, et al. Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarction. Mol Cell Biochem 2003;246:75-82.

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