Q & A on Benefits of Coenzyme Q10

A 3-year Australian study found that when patients who underwent bypass surgerywere given coenzyme Q10 for a week or more before the operation, their heartmuscle tolerated stress better, recovered more quickly, and had better pumpingability after surgery than did the heart muscle in patients given placebo.¹
Should patients who are scheduled to undergo bypass surgery routinely begiven coenzyme Q10 before the operation?
-Richard S. Banfield, MD
  New Canaan, Conn

REFERENCE:1. Rosenfeldt F. Paper presented at: Second Conference of the International Coenzyme Q10 Association;December 2000; Frankfurt/Main, Germany.

The benefits of coenzyme Q10 (ubiquinone) in both cardiac and noncardiacconditions have been widely touted. Unfortunately, data are notas strong as proponents often state. Many of the studies are unblindedor not randomized. The well-designed studies tend to be small, andthe results are often negative.^1,2

Although long-term coenzyme Q10 therapy for patients with congestiveheart failure has been advocated, the compound is very expensive and its benefitsremain unproven. Similarly, the data for perioperative use of coenzymeQ10 are generally uncontrolled and unblinded.

Dr Rosenfeldt's data regarding ubiquinone are provocative; however, numerousparameters affect the length of hospital stay, and it is difficult to believethat a simple intervention could have such a profound effect. Indeed, many smallstudies have demonstrated great benefit, while subsequent large-scale studies(eg, the ELITE studies³ and the vesnarinone trials⁴) had negative results. Thus,confirmatory studies need to be done before routine administration of coenzymeQ10 can be recommended for patients who are to undergo bypass surgery.

-Stephen S. Gottlieb, MD,
  Professor of Medicine
  University of Maryland
  Baltimore

REFERENCES:1. Watson PS, Scalia GM, Galbraith A, et al. Lack of effect of coenzyme Q on left ventricular function inpatients with congestive heart failure. J Am Coll Cardiol. 1999;33:1549-1552.
2. Khatta M, Alexander BS, Krichten CM, et al. The impact of coenzyme Q10 in patients with congestiveheart failure. Ann Intern Med. 2000;132:636-640.
3. Pitt B, Poole-Wilson PA, Segal R, et al, for the Losartan Heart Failure Survival Study ELITE II. Effect oflosartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial.Lancet. 2000;355:1582-1587.
a4. Cohn JN, Goldstein SO, Greenberg BH, et al, for the Vesnarinone Trial Investigators. A dose-dependentincrease in mortality with vesnarinone among patients with severe heart failure. N Engl J Med. 1998;339:1810-1816.