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meta analysis2,149 participants

CoQ10 for Heart Failure: 2017 Meta-Analysis of 14 RCTs

Reviewed by·PharmD, BCPS

This content is for informational purposes only and does not constitute medical advice. Consult your healthcare provider before starting any supplement. Full disclaimer

TL;DR — Quick Answer

A 2017 meta-analysis of 14 RCTs (n=2,149) found that CoQ10 supplementation (100-300mg/day) significantly improved left ventricular ejection fraction by 3.67% and reduced mortality in heart failure patients. The landmark Q-SYMBIO trial showed a 43% reduction in cardiovascular mortality with 300mg/day CoQ10.

Key Findings

  • CoQ10 supplementation improved left ventricular ejection fraction (LVEF) by 3.67% (95% CI: 1.60-5.74, p < 0.001)
  • The Q-SYMBIO trial (n=420) showed 43% reduction in cardiovascular mortality with 300mg/day CoQ10 over 2 years
  • Exercise capacity improved significantly in CoQ10-supplemented patients (SMD = 0.62, p = 0.01)
  • NYHA functional class improved by an average of 0.5 grades with CoQ10 supplementation
  • Optimal dosing was 100-300mg/day, with higher doses needed for more severe heart failure

Study Details

The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO
Mortensen SA, Rosenfeldt F, Kumar A, et al. — JACC: Heart Failure (2014)
CoQ10 300mg/day reduced major adverse cardiovascular events by 43% and cardiovascular mortality by 43% over 2 years
420 participantsHigh

Practical Takeaway

For heart failure patients, 100-300mg/day of CoQ10 (ubiquinol form preferred for better absorption) as an adjunct to standard therapy is supported by strong evidence. Statin users should also consider CoQ10 supplementation, as statins deplete CoQ10 levels. Always consult a cardiologist before adding CoQ10 to heart failure treatment.

Summary

A systematic review and meta-analysis of 14 randomized controlled trials examining the effects of coenzyme Q10 supplementation on heart failure symptoms, left ventricular ejection fraction, and mortality in 2,149 heart failure patients.

Related Supplements

Coenzyme Q10 (CoQ10)

Frequently Asked Questions

Does CoQ10 help with heart failure?

Yes. A meta-analysis of 14 RCTs found CoQ10 supplementation improved ejection fraction by 3.67% and exercise capacity in heart failure patients. The Q-SYMBIO trial showed a 43% reduction in cardiovascular mortality with 300mg/day. CoQ10 is recommended as adjunctive therapy alongside standard treatment.

How much CoQ10 should heart failure patients take?

Clinical trials used 100-300mg/day, with the strongest mortality data at 300mg/day (Q-SYMBIO trial). The ubiquinol form is preferred over ubiquinone for better absorption, especially in older adults. Split doses (100mg three times daily with meals) optimize absorption.

Should I take CoQ10 if I am on a statin?

Statins inhibit the mevalonate pathway, which reduces both cholesterol and CoQ10 production. While statin-CoQ10 depletion does not cause problems for everyone, those experiencing statin-related muscle symptoms may benefit from 100-200mg/day of CoQ10. Discuss with your doctor.

What is the difference between ubiquinol and ubiquinone CoQ10?

Ubiquinol is the reduced (active) form of CoQ10, while ubiquinone must be converted by the body. Ubiquinol has 3-6x better bioavailability, especially in people over 40 whose conversion ability declines. Most clinical heart failure trials used ubiquinone, but ubiquinol may achieve similar results at lower doses.

References

  1. Mortensen SA, Rosenfeldt F, Kumar A, et al. (2014). The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC: Heart Failure. DOI PubMed
  2. Lei L, Liu Y (2017). Efficacy of coenzyme Q10 in patients with cardiac failure: a meta-analysis of clinical trials. BMC Cardiovascular Disorders. DOI PubMed