Coenzyme Q10, rosuvastatin, and clinical outcomes in heart failure: a pre-specified substudy of CORONA (controlled rosuvastatin multinational study in heart failure)
John J V McMurray, Peter Dunselman, Hans Wedel, John G F Cleland, Magnus Lindberg, Ake Hjalmarson, John Kjekshus, Finn Waagstein, Eduard Apetrei, Vivencio Barrios, Michael Böhm, Gabriel Kamenský, Michel Komajda, Vyacheslav Mareev, John Wikstrand, CORONA Study Group, John J V McMurray, Peter Dunselman, Hans Wedel, John G F Cleland, Magnus Lindberg, Ake Hjalmarson, John Kjekshus, Finn Waagstein, Eduard Apetrei, Vivencio Barrios, Michael Böhm, Gabriel Kamenský, Michel Komajda, Vyacheslav Mareev, John Wikstrand, CORONA Study Group
Abstract
Objectives: The purpose of this study was to determine whether coenzyme Q₁₀ is an independent predictor of prognosis in heart failure.
Background: Blood and tissue concentrations of the essential cofactor coenzyme Q₁₀ are decreased by statins, and this could be harmful in patients with heart failure.
Methods: We measured serum coenzyme Q₁₀ in 1,191 patients with ischemic systolic heart failure enrolled in CORONA (Controlled Rosuvastatin Multinational Study in Heart Failure) and related this to clinical outcomes.
Results: Patients with lower coenzyme Q₁₀ concentrations were older and had more advanced heart failure. Mortality was significantly higher among patients in the lowest compared to the highest coenzyme Q₁₀ tertile in a univariate analysis (hazard ratio: 1.50, 95% confidence interval: 1.04 to 2.6, p = 0.03) but not in a multivariable analysis. Coenzyme Q₁₀ was not an independent predictor of any other clinical outcome. Rosuvastatin reduced coenzyme Q₁₀ but there was no interaction between coenzyme Q₁₀ and the effect of rosuvastatin.
Conclusions: Coenzyme Q₁₀ is not an independent prognostic variable in heart failure. Rosuvastatin reduced coenzyme Q₁₀, but even in patients with a low baseline coenzyme Q₁₀, rosuvastatin treatment was not associated with a significantly worse outcome. (Controlled Rosuvastatin Multinational Study in Heart Failure [CORONA]; NCT00206310).
Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Source: PubMed