Coenzyme Q₁₀: An Independent Predictor of Mortality in Chronic Heart Failure

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• 作者：Sarah L. Molyneux ; Christopher M. Florkowski ; Peter M. George ; Anna P. Pilbrow ; Christopher M. Frampton ; Michael Lever ; A. Mark Richards
• 关键词：chronic heart failure ; coenzyme Q₁₀ ; mortality
• 刊名：Journal of the American College of Cardiology
• 出版年：2008
• 出版时间：28 October 2008
• 年：2008
• 卷：52
• 期：18
• 页码：1435-1441
• 全文大小：413 K

文摘

Objectives

The aim of this study was to investigate the relationship between plasma coenzyme Q₁₀ (CoQ₁₀) and survival in patients with chronic heart failure (CHF).

Background

Patients with CHF have low plasma concentrations of CoQ₁₀, an essential cofactor for mitochondrial electron transport and myocardial energy supply. Additionally, low plasma total cholesterol (TC) concentrations have been associated with higher mortality in heart failure. Plasma CoQ₁₀ is closely associated with low-density lipoprotein cholesterol (LDL-C), which might contribute to this association. Therefore we tested the hypothesis that plasma CoQ₁₀ is a predictor of total mortality in CHF and could explain this association.

Methods

Plasma samples from 236 patients admitted to the hospital with CHF, with a median (range) duration of follow-up of 2.69 (0.12 to 5.75) years, were assayed for LDL-C, TC, and total CoQ₁₀.

Results

Median age at admission was 77 years. Median (range) CoQ₁₀ concentration was 0.68 (0.18 to 1.75) μmol/l. The optimal CoQ₁₀ concentration for prediction of mortality (established with receiver-operator characteristic [ROC] curves) was 0.73 μmol/l. Multivariable analysis allowing for effects of standard predictors of survival—including age at admission, gender, previous myocardial infarction, N-terminal peptide of B-type natriuretic peptide, and estimated glomerular filtration rate (modification of diet in renal disease)—indicated CoQ₁₀ was an independent predictor of survival, whether dichotomized at the ROC curve cut-point (hazard ratio [HR]: 2.0; 95 % confidence interval [CI]: 1.2 to 3.3) or the median (HR: 1.6; 95 % CI: 1.0 to 2.6).

Conclusions

Plasma CoQ₁₀ concentration was an independent predictor of mortality in this cohort. The CoQ₁₀ deficiency might be detrimental to the long-term prognosis of CHF, and there is a rationale for controlled intervention studies with CoQ₁₀.