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      Efficacy of coenzyme Q10 in patients with cardiac failure: a meta-analysis of clinical trials

      research-article
      1 , 2 ,
      BMC Cardiovascular Disorders
      BioMed Central
      Coenzyme Q10, Cardiac failure, Exercise capacity, Placebo

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          Abstract

          Background

          The therapeutic efficacy of coenzyme Q10 on patients with cardiac failure remains controversial. We pooled previous clinical studies to re-evaluate the efficacy of coenzyme Q10 in patients with cardiac failure.

          Methods

          We searched PubMed, Cochrane Library, EMBASE, and Clinical Trials.gov databases for controlled trials. The endpoints were death, left heart ejection fraction, exercise capacity, and New York Heart Association (NYHA) cardiac function classification after treatment. The pooled risk ratios (RRs) and standardized mean difference (SMD) were used to assess the efficacy of coenzyme Q10.

          Results

          A total of 14 RCTs with 2149 patients met the inclusion criteria and were included in the analysis. Coenzyme Q10 decreased the mortality compared with placebo (RR = 0.69; 95% CI = 0.50–0.95; P = 0.02; I 2  = 0%). A greater improvement in exercise capacity was established in patients who used coenzyme Q10 than in those who used placebo (SMD = 0.62; 95% CI = 0.02–0.30; P = 0.04; I 2  = 54%). No significant difference was observed in the endpoints of left heart ejection fraction between patients who received coenzyme Q10 and the patients in whom placebo was administered (SMD = 0.62; 95% CI = 0.02–1.12; P = 0.04; I 2  = 75%). The two types of treatment resulted in obtaining similar NYHA classification results (SMD = −0.70; 95% CI = −1.92–0.51; P = 0.26; I 2  = 89%).

          Conclusion

          Patients with heart failure who used coenzyme Q10 had lower mortality and a higher exercise capacity improvement than the placebo-treated patients with heart failure. No significant differences between the efficacy of the administration of coenzyme Q10 and placebo in the endpoints of left heart ejection fraction and NYHA classification were observed.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12872-017-0628-9) contains supplementary material, which is available to authorized users.

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          Most cited references34

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          2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines.

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            Biochemical functions of coenzyme Q10.

            F. Crane (2001)
            Coenzyme Q is well defined as a crucial component of the oxidative phosphorylation process in mitochondria which converts the energy in carbohydrates and fatty acids into ATP to drive cellular machinery and synthesis. New roles for coenzyme Q in other cellular functions are only becoming recognized. The new aspects have developed from the recognition that coenzyme Q can undergo oxidation/reduction reactions in other cell membranes such as lysosomes. Golgi or plasma membranes. In mitochondria and lysosomes, coenzyme Q undergoes reduction/oxidation cycles during which it transfers protons across the membrane to form a proton gradient. The presence of high concentrations of quinol in all membranes provides a basis for antioxidant action either by direct reaction with radicals or by regeneration of tocopherol and ascorbate. Evidence for a function in redox control of cell signaling and gene expression is developing from studies on coenzyme Q stimulation of cell growth, inhibition of apoptosis, control of thiol groups, formation of hydrogen peroxide and control of membrane channels. Deficiency of coenzyme Q has been described based on failure of biosynthesis caused by gene mutation, inhibition of biosynthesis by HMG coA reductase inhibitors (statins) or for unknown reasons in ageing and cancer. Correction of deficiency requires supplementation with higher levels of coenzyme Q than are available in the diet.
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              The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial.

              This randomized controlled multicenter trial evaluated coenzyme Q10 (CoQ10) as adjunctive treatment in chronic heart failure (HF).
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                Author and article information

                Contributors
                nguan5370868@sina.com
                +8618992246959 , 476559924@qq.com
                Journal
                BMC Cardiovasc Disord
                BMC Cardiovasc Disord
                BMC Cardiovascular Disorders
                BioMed Central (London )
                1471-2261
                24 July 2017
                24 July 2017
                2017
                : 17
                : 196
                Affiliations
                [1 ]Department of Cardiology, Yulin Traditional Chinese Medicine Hospital, Yulin, 719000 China
                [2 ]First Department of Cardiology, Yulin Second Hospital, South Wenhua Road, Yulin, 719000 China
                Author information
                http://orcid.org/0000-0002-8444-0497
                Article
                628
                10.1186/s12872-017-0628-9
                5525208
                28738783
                9a020fae-bec9-42fa-b8ac-1bbf335e9937
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 18 May 2017
                : 12 July 2017
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Cardiovascular Medicine
                coenzyme q10,cardiac failure,exercise capacity,placebo
                Cardiovascular Medicine
                coenzyme q10, cardiac failure, exercise capacity, placebo

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