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Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarction

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Abstract

In a randomized, double-blind, controlled trial, the effects of oral treatment with coenzyme Q10 (CoQ10, 120 mg/day), a bioenergetic and antioxidant cytoprotective agent, were compared for 1 year, on the risk factors of atherosclerosis, in 73 (CoQ, group A) and 71 (B vitamin group B) patients after acute myocardial infarction (AMI). After 1 year, total cardiac events (24.6 vs. 45.0%, p < 0.02) including non-fatal infarction (13.7 vs. 25.3%, p < 0.05) and cardiac deaths were significantly lower in the intervention group compared to control group. The extent of cardiac disease, elevation in cardiac enzymes, left ventricular enlargement, previous coronary artery disease and elapsed time from symptom onset to infarction at entry to study showed no significant differences between the two groups. Plasma level of vitamin E (32.4 ± 4.3 vs. 22.1 ± 3.6 umol/L) and high density lipoprotein cholesterol (1.26 ± 0.43 vs. 1.12 ± 0.32 mmol/L) showed significant (p < 0.05) increase whereas thiobarbituric acid reactive substances, malondialdehyde (1.9 + 0.31 vs. 3.1 + 0.32 pmol/L) and diene conjugates showed significant reduction respectively in the CoQ group compared to control group. Approximately half of the patients in each group (n = 36 vs. 31) were receiving lovastatin (10 mg/day) and both groups had a significant reduction in total and low density lipoprotein cholesterol compared to baseline levels. It is possible that treatment with CoQ10 in patients with recent MI may be beneficial in patients with high risk of atherothrombosis, despite optimal lipid lowering therapy during a follow-up of 1 year. Adverse effect of treatments showed that fatigue (40.8 vs. 6.8%, p < 0.01) was more common in the control group than CoQ group.

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References

  1. Davies M: Stability and unstability: Two faces of coronary atherosclerosis. Circulation 94: 2013-2020, 1996

    Google Scholar 

  2. Davies MJ: Pathophysiology of acute coronary syndromes. Heart 83: 361-366, 2000

    Google Scholar 

  3. Libby P, Aikawa M: New insights in plaque stabilization by lipid lowering. Drugs (suppl 1): 9-13, 1998

    Google Scholar 

  4. Weissberg PL: Atherogenesis: Current understanding of the causes of atheroma. Heart 83: 247-252, 2000

    Google Scholar 

  5. Toussaint JF, La Muraglia GM, Southern JF et al.: Magnetic resonance images lipid, fibrous, calcified, hemorrhagic and thrombotic components of human atherosclerosis in vivo. Circulation 94: 932-938, 1996

    Google Scholar 

  6. MAAS Investigators: Effect of simvastatin on coronary atheroma: The Multicentre Anti-Atheroma Study (MAAS). Lancet 334: 633-638, 1994

    Google Scholar 

  7. Shepherd J, Cobbe S, Ford I et al.: Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 333: 1301-1307, 1995

    Google Scholar 

  8. LIPID Study Group: Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. The Long-term Intervention with Pravastatin in Ischaemic Disease (LIPID) study. N Engl J Med 339: 1349-1357, 1998

    Google Scholar 

  9. Singh RB, Singh NK, Rastogi SS, Wander GS, Aslam, Onouchi Z, Kummerow FA, Nangia S: Antioxidant effects of lovastatin and vitamin E on experimental atherosclerosis in rabbits. Cardiovasc Drug Ther 11: 575-580, 1997

    Google Scholar 

  10. Singh RB, Shinde SN, Chopra RK, Niaz MA, Thakur AS, Onouchi Z: Effect of coenzyme Q10 on experimental atherosclerosis and chemical composition and quality of atheroma in rabbits. Atherosclerosis 148: 275-282, 2000

    Google Scholar 

  11. Thomas SR, Witting PK, Stocker R: A role of reduced coenzyme Q in atherosclerosis. BioFactors 9: 207-224, 1999

    Google Scholar 

  12. Tomasetti M, Alleva R, Solenghi MD, Littarru GP: Distribution of antioxidants among blood components and lipoproteins: Significance of lipids/CoQ10 ratio as a possible marker of increased risk of atherosclerosis. BioFactors 9: 225-230, 1999

    Google Scholar 

  13. Kuklinski B, Weissenbacher E, Fahnrich A: Coenzyme Q10 and antioxidants in acute myocardial infarction. Mol Aspects Med 15(suppl): 143-147, 1994

    Google Scholar 

  14. Singh RB, Wander GS, Rastogi A, Shukla PK et al.: Randomized, double blind, placebo controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc Drug Ther 12: 347-353, 1998

    Google Scholar 

  15. Langsjoen PH, Langsjoen AM: Overview of the use of coenzyme Q10 in cardiovascular disease. BioFactors 9: 273-284, 1999

    Google Scholar 

  16. Hill MF, Singal PK: Antioxidant and oxidative stress changes during heart failure subsequent to myocardial infarction in rats. Am J Pathol 148: 291-300, 1996

    Google Scholar 

  17. Mckay RG, Pfeffer MA, Pasternak RC: Left ventricular remodeling following myocardial infarction: A corollary to infarct expansion. Circulation 74: 693-702, 1986

    Google Scholar 

  18. Niibori K, Wroblewski KP, Yokoyama H, Juan A, Crestanello JA, Whitman GJR: Bioenergetic effect of liposomal coenzyme Q10 on myocardial ischaemia reperfusion injury. BioFactors 9: 307-313, 1999

    Google Scholar 

  19. Brubacher G, Vuilleumier JP, Inairtis HC, Roth Meds: Vitamin C: Clinical Biochemistry. Principles and Methods, Vol. 2. De Gruyter, Berlin, 1974, pp 989-997

    Google Scholar 

  20. Vuilleumier JP, Keller HE, Gysel D, Hunziker F: Clinical chemical methods for the routine assessment of the vitamin status in human population, part 1. The fat soluble vitamin A, E and beta-carotene. Int J Vit Nutr Res 58: 265-272, 1983

    Google Scholar 

  21. Esterbaur H, Cheeseman K: Determination of aldehyde peroxidation products MDA and 4 hydroxynonenal. Meth Enzymol 186: 407-421, 1990

    Google Scholar 

  22. Niato C, Kawamura M, Yamamoto Y: Lipid peroxides as the initiating factor of atherosclerosis. NY Acad Sci 676: 27-45, 1993

    Google Scholar 

  23. Lunec J, Hallovan SP, White AG, Dormandy TL: Free radical oxidation (peroxidation) products in serum and synovial fluids in rheumatoid arthritis. J Rheumatol 8: 233-245, 1981

    Google Scholar 

  24. Allain CC, Poon LS, Chan, Richmond W, Fu PC: Enzymatic determination of total serum cholesterol. Clin Chem 20: 470-475, 1974

    Google Scholar 

  25. Finley PR, Schifmjan RB, William RJ, Lichti DA: Cholesterol in high density lipoprotein: Use of magnesium/dextran sulphate in its enzymatic measurement. Clin Chem 24: 931-933, 1978

    Google Scholar 

  26. Friedwald WT, Levy RI, Fredrickson DS: Estimation of low density lipoprotein cholesterol concentration in plasma without use of the preparative ultracentrifuge. Clin Chem 18: 499-502, 1972

    Google Scholar 

  27. Bucolo G, Devi H: Quantitative determination of serum triglycerides by the use of enzymes. Clin Chem 79: 476-482, 1973

    Google Scholar 

  28. Herzog WR, Schlossberg ML, Mortensen SA, Serebruany VL: Dietary supplementation with coenzyme Q10 reduces platelet aggregability in swine. Coenzyme Q. Res Biol Med 3: 5-8, 1995

    Google Scholar 

  29. Serebruany V, Ordonez JV, Herzog WR, Morten R, Mortensen SA, Folkers K, Gurbel PA: Dietary coenzyme Q10 supplementation alters platelet size and inhibits human Vitronectin (CDSI/CD61) receptor expression. J Cardiovasc Pharmacol 29: 16-22, 1997

    Google Scholar 

  30. Kamikawa T, Kobayashi A, Yamashita T, Yahashi H, Yamasaki N: Effects of coenzyme Q10 on exercise tolerance in chronic stable angina pectoris. Am J Cardiol 56: 247-257, 1985

    Google Scholar 

  31. Hofman-Bang C, Rehnqvist N, Swedberg K, Astrom H: Coenzyme Q10 as an adjunctive in treatment of congestive heart failure. J Am Coll Cardiol 19(suppl): 774-776, 1992

    Google Scholar 

  32. Kontush A, Reich A, Baum K, Spranger T, Finckh B, Kohlschutter A, Beisiegel U: Plasma ubiquinol is decreased in patients with hyperlipidemia. Atherosclerosis 129: 119-126, 1997

    Google Scholar 

  33. Yokoyama H, Lingle DM, Crestanello JA et al.: Coenzyme Q10 protects coronary endothelial function from ischaemia reperfusion injury via an antioxidant effect. Surgery 120: 189-196, 1996

    Google Scholar 

  34. Baggio G, Gandini R, Plancher AC, Passeri M, Carmosino G: Italian multicenter study on the safety and efficacy of coenzyme Q10 as adjunctive therapy in heart failure. Mol Aspects Med 15(suppl): 287-294, 1994

    Google Scholar 

  35. Soja AM, Mortensen SA: Treatment of congestive heart failure with coenzyme Q10 illuminated by meta-analyses of clinical trials. Mol Aspects Med 18(suppl): 1591-1568, 1997

    Google Scholar 

  36. Beere PA, Glagov S, Zarins CK: Retarding effect of lowered heart rate on coronary atherosclerosis. Science 226: 180-182, 1984

    Google Scholar 

  37. Kaplan JR, Manuck SB, Adams MR et al.: Inhibition of coronary atherosclerosis by propranolol on behaviorally predisposed monkeys fed an atherogenic diet. Circulation 86: 1364-1372, 1987

    Google Scholar 

  38. Kaplan JR, Manuck SB, Clarkson TB: The influence of heart rate on coronary atherosclerosis. J Cardiovasc Pharm 10(suppl 2): S100-102, 1987

    Google Scholar 

  39. Goldberger AL: Non-linear dynamics for clinicians: Chaos theory, fractals and complexity at the bedside. Lancet 347: 1312-1314, 1996

    Google Scholar 

  40. Quinn PJ, Fabisiak JP, Kagan VE: Expansion of antioxidant function of vitamin E by coenzyme Q. BioFactors 4: 149-154, 1999

    Google Scholar 

  41. Stocker R, Bowry VW, Frei B: Ubiquinol-10 protects human low density lipoproteins more efficiently against lipid peroxidation than does alpha-tocopherol. Proc Natl Acad Sci USA 88: 1646-1650, 1991

    Google Scholar 

  42. Jappensen J, Hein HO, Suadicani P, Gyntelberg F: Relation of high triglyceride-low HDL cholesterol and LDL cholesterol to the incidence of ischaemic heart disease: An eight year follow up in the Copenhagen male study. Art Thromb Vasc Biol 17: 1114-1120, 1997

    Google Scholar 

  43. Littarru GP, Ho L, Folkers K: Deficiency of coenzyme Q10 in human heart disease II. Int J Vit Nutr Res 42: 291-295, 1972

    Google Scholar 

  44. Littarru GP, Ho L, Folkers K: Deficiency of coenzyme Q10 in human heart disease. Int J Vit Nutr Res 42: 291-295, 1972

    Google Scholar 

  45. Langsjoen PH, Langsjoen AM: Coenzyme Q10 in cardiovascular disease with emphasis on heart failure and myocardial ischaemia. Asia Pacif Heart J 7: 160-168, 1998

    Google Scholar 

  46. Thomas SR, Neuzil J, Stocker R: Co-supplementation with coenzyme Q prevents the prooxidant effect of alphatocopherol and increases the resistance of LDL to transition metal-dependent oxidation initiation. Arterio Thromb Vas Biol 16: 687-696, 1996

    Google Scholar 

  47. Aejmelaeus R, Metsa-Ketela T, Laippala P, Alho H, Solakvi T: Ubiquinol-10 and total peroxyl radical trapping capacity of LDL lipoproteins during aging: The effects of Q10 supplementation. Mol Aspects Med 18(suppl): 113-120, 1997

    Google Scholar 

  48. Alleva R, Tomasetti M, Battino M, Curatola G, Littarru GP, Folkers K: The role of coenzyme Q10 and vitamin E on peroxidation of human low density subfractions. Proc Natl Acad Sci USA 92: 9388-9393, 1995

    Google Scholar 

  49. Rudney H, Nambudiri AMD, Ranganathan S: The regulation of the synthesis of coenzyme Q in fibroblasts and in heart muscle. In: K. Folkers, Y. Yamamura (eds). Biomedical and Clinical Aspects of Coenzyme Q. Elsevier North Holland Press, Amsterdam, 1981, pp 279-290

    Google Scholar 

  50. Ghirlanda G, Oradei A, Manto A et al.: Evidence of plasma coenzyme Q10 lowering effect by HMG-CoA reductase inhibitors: A double blind placebo controlled study. J Clin Pharmacol 33: 226-229, 1993

    Google Scholar 

  51. Bargossi AM, Battino M, Gaddi A et al.: Exogenous coenzyme Q10 preserves plasma ubiquinone levels in patients treated with 3-hydroxy-3-methymglutaryl coenzyme A reductase inhibitors. Int J Clin Lab Res 24: 171-176, 1994

    Google Scholar 

  52. Mortensen SA, Leth A, Agner E, Rohde M: Dose related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Mol Aspects Med 18(suppl): 137-144, 1997

    Google Scholar 

  53. Lopez-Lluch G, Barroso MP, Martin SF et al.: Role of plasma membrane coenzyme Q on the regulation of apoptosis. BioFactors 9: 171-178, 1999

    Google Scholar 

  54. Burke A, Farb A, Malcom G et al.: Coronary risk factors and plaque morphology in men with coronary disease who died suddenly. N Engl J Med 336: 1276-1282, 1997

    Google Scholar 

  55. Ross R: Atherosclerosis, an inflammatory disease. N Engl J Med 340: 115-126, 1999

    Google Scholar 

  56. Arbustini E, Dal Bello P, Morbini P et al.: Plaque erosion is a major substrate for coronary thrombosis in acute myocardial infarction. Heart 82: 269-272, 1999

    Google Scholar 

  57. Anand SS, Yusuf S, Vuksan V et al.: Differences in risk factors, atherosclerosis and cardiovascular disease between ethnic groups in Canada: The Study of Health Assessment and Risk in Ethnic Groups (SHARE). Lancet 356: 279-284, 2000

    Google Scholar 

  58. Singh RB, Niaz MA, Rastogi SS, Sharma JP, Kumar R, Bishnoi I, Beegom R: Plasma levels of antioxidant vitamins and oxidative stress in patients with suspected acute myocardial infarction. Acta Cardiol 49: 411-452, 1994

    Google Scholar 

  59. Grech ED, Jackson M, Ramsdale DR: Reperfusion injury after acute myocardial infarction. Br Med J 310: 477-478, 1995

    Google Scholar 

  60. Khaper N, Singal PK: Effects of after load reducing drugs on the pathogenesis of antioxidant changes and congestive heart failure in rats. J Am Coll Cardiol 219: 856-861, 1997

    Google Scholar 

  61. Morisco C, Trimarco B, Condorelh M: In: K. Folkers, S.A. Mortension, G.P. Littarru, T. Yamagam, G. Lenaz (eds): Effect of coenzyme therapy in patients with congestive heart failure: A long term multicentre randomized study. Clin Invest 71(suppl): 134-136, 1993

    Google Scholar 

  62. Soja AM, Mortensen SA: Treatment of congestive heart failure with coenzyme Q10 illuminated by metaanalysis of clinical trials. Mol Asp Med 18(suppl): 159-168, 1997

    Google Scholar 

  63. Swedberg K, Hoffman-Bang C, Rehnqvist N, Astrom H: Coenzyme Q10 as adjunctive in treatment of congestive heart failure. J Cardiac Fail 1: 101-107, 1995

    Google Scholar 

  64. Shi H, Noguchi N, Niki E: Dynamics of antioxidant action of ubiquinol: A reappraisal. Biofactors 9: 141-148, 1999

    Google Scholar 

  65. Mortensen SA, Leth A, Agner E, Rohde M: Coenzyme Q10: Clinical benefits with biochemical correlates suggesting a scientific breakthrough in the management of chronic heart failure. Int J Tissue React 12: 155-162, 1990

    Google Scholar 

  66. Beyer R: An analysis of coenzyme Q in free radical generation and as an antioxidant. Biochem Cell Biol 70: 390-403, 1992

    Google Scholar 

  67. Permanetter B, Roessy W, Klein G, Weingartner F, Seidl KF, Bloemer H: Ubiquinone (coenzyme Q10) in the long term treatment of cardiomyopathy. Eur Heart J 13: 1528-1533, 1992

    Google Scholar 

  68. Watson PS, Scalia GM, Galbraith A, Burstow DJ, Bett N, Aroney CN: Lack of effect of coenzyme Q on left ventricular function in patients with congestive heart failure. J Am Coll Cardiol 33: 1549-1552, 1999

    Google Scholar 

  69. Khatta M, Alexander BS, Krichten CM, Freudenberger R, Robinson SW, Gottlieb SS: The effect of coenzyme Q10 in patients with congestive heart failure. Ann Intern Med 132: 636-640, 2000

    Google Scholar 

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Singh, R.B., Neki, N.S., Kartikey, K. et al. Effect of coenzyme Q10 on risk of atherosclerosis in patients with recent myocardial infarction. Mol Cell Biochem 246, 75–82 (2003). https://doi.org/10.1023/A:1023408031111

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