Coenzyme Q10 for Patients With Cardiovascular Disease JACC Focus Seminar

Coenzyme Q(10) (CoQ(10)) is a naturally occurring compound that is found in animals and all humans. It has a fundamental role in cellular energy production. Although it is produced in the body, tissue deficiency can occur due to medications such as statins, which inhibit the mevalonate pathway. The clinical syndromes of statin-associated muscle symptoms (SAMS) and some of the features observed in patients with heart failure (HF) may be related to blood and tissue deficiency of CoQ(10). Numerous clinical trials of CoQ(10) in SAMS have yielded conflicting results. Yet, the weight of evidence as reflected in meta-analyses supports the use of exogenous CoQ(10) in SAMS. In patients with HF, large-scale randomized clinical trials are lacking, although one relatively contemporary trial, Q-SYMBIO, suggests an adjunctive role for CoQ(10). The possibility that statin-related CoQ(10) deficiency may play a role in patients with diastolic HF is an intriguing hypothesis that warrants further exploration. (C) 2021 by the American College of Cardiology Foundation.