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Effect of coenzyme Q10 therapy in patients with congestive heart failure: a long-term multicenter randomized study

C Morisco, B Trimarco, M Condorelli
Clinical Investigator 1993 71(8 Suppl):S134-S136

Bibliography

PubMed
PMID 8241697
DOI
10.1007/BF00226854
Funding
A specific funding source was not identified in the accessible publication record checked during this audit.
Competing interests
A specific author conflict-of-interest statement was not identified in the accessible publication record checked during this audit.

Study snapshot

DesignRandomized, double-blind, placebo-controlled multicenter trial
ModelAdults with chronic NYHA class III-IV congestive heart failure receiving conventional therapy were randomized to adjunctive CoQ10 or placebo.
Sample641 randomized: 319 CoQ10 and 322 placebo.
InterventionCoQ10 2 mg/kg/day plus conventional heart-failure therapy versus placebo plus conventional therapy.
Duration1 year
EndpointsHospitalization for worsening heart failure; Pulmonary edema; Cardiac asthma; Arrhythmias; NYHA functional class; Mortality

What the study showed, in plain terms

This older multicenter double-blind trial randomized 641 patients with advanced NYHA class III-IV chronic heart failure to CoQ10 2 mg/kg/day or placebo for one year on top of conventional therapy.

CoQ10 was associated with fewer hospitalizations for worsening heart failure (73 vs 118) and fewer episodes of pulmonary edema (20 vs 51), cardiac asthma (97 vs 198) and arrhythmias (21 vs 33). NYHA class improved more in the CoQ10 group.

Deaths were numerically lower with CoQ10 (16 vs 21) but the publication did not establish a statistically significant mortality benefit. The trial is clinically interesting but predates modern guideline-directed therapy.

Key findings

Hospitalization for worsening heart failure: 73 CoQ10 vs 118 placebo.

Pulmonary edema: 20 vs 51; cardiac asthma: 97 vs 198; both favored CoQ10.

Arrhythmias: 21 CoQ10 vs 33 placebo.

NYHA functional class improved in both groups, with greater improvement reported in the CoQ10 group.

Deaths: 16 CoQ10 vs 21 placebo; no significant mortality difference was established.

What this study can and cannot tell us

The trial was conducted in 1993, before contemporary HFrEF therapies such as ARNI, mineralocorticoid receptor antagonists at current standards, and SGLT2 inhibitors.

The report is brief and provides less methodological detail than modern RCT publications.

The study did not establish a statistically significant mortality reduction despite favorable morbidity signals.

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