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- W2100083586 abstract "Energy starvation of the myocardium is a dominant feature of heart failure (HF) leading to an important role for agents that can enhance myocardial metabolism and augment energy production. Coenzyme Q10 (CoQ10) fulfils this role with previous double-blind trials though positive have been underpowered to detect major clinical endpoints such as mortality. Q-SYMBIO is the first double-blind trial of CoQ10 in HF addressing survival. Patients in NYHA Class III or IV HF who were receiving optimal pharmacologic therapy were randomly assigned to either CoQ10 100 mg three times daily or placebo. The primary long-term endpoint was composite MACE (major adverse cardiovascular events) including unplanned hospitalisations due to worsening heart failure, cardiovascular death, urgent cardiac transplantation and mechanical support, using a time to first event analysis. A total of 420 patients from 17 international centres were enrolled with a follow-up time of 2 years. There was a significantly greater improvement of NYHA Class in the CoQ10 group compared to placebo (p=0.047). The primary endpoint was reached by 14% of the patients in the CoQ10 group vs. 25% of patients in the placebo group; HR CoQ10 vs. placebo 2.0(CI 1.3-3.2); p=0.003 by intention to treat analysis. CoQ10 treated patients had lower cardiovascular mortality: 8% vs. 15% (p=0.02) and lower incidence of hospitalisations for HF (p=0.05). All cause mortality was also lower in the CoQ10 group: 9% vs. 17%; HR CoQ10 vs. placebo 2.1(CI 1.2-3.8); p=0.01. There were fewer adverse events in the CoQ10 group compared to placebo (p=0.073). CoQ10 supplementation in patients with moderate to severe HF receiving optimal conventional therapy: is safe; improves survival due to reductions in cardiovascular- and all-cause mortality; is associated with reduction in symptoms and hospitalisations for worsening HF. Thus it represents an important advance in therapy." @default.
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- W2100083586 date "2013-08-01" @default.
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- W2100083586 title "Coenzyme Q10 Therapy Blocks the Vicious Metabolic Cycle in Chronic Heart Failure" @default.
- W2100083586 doi "https://doi.org/10.1016/j.cardfail.2013.06.085" @default.
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