EFFECT OF CO-ENZYME Q10 ON CARDIAC FUNCTION IN PATIENTS WITH CHRONIC HEART FAILURE: A META-ANALYSIS OF PLACEBO-CONTROLLED TRIALS
S.L. Whorlow*, H. Krum.
Monash University, Alfred Hospital, Prahran, Victoria.
A number of studies have suggested that co-enzyme Q10 (CoQ) improves cardiac function in patients with chronic heart failure (CHF). This evidence is based largely on small, uncontrolled and/or non-blinded trials. However, there have been few well-designed, randomised, double-blind, placebo (PBO)-controlled clinical trials reported.
We have performed a meta-analysis of the available trials that fulfil these criteria, to determine the effectiveness of Co! as an adjunct to conventional therapy (digoxin, diuretics ± ACE inhibitors) in pts with CHF. From these trials (all cross-over design), the only end-points of cardiac function able to be analysed in this way were ejection fraction (EF) at rest, EF during exercise and maximal work capacity during exercise. Values for these parameters following CoQ or PBO treatment were used to perform a meta-analysis on effect size with pooled weighted mean difference (PWMD) and 95% confidence interval (CI) calculated by the DerSimonian-Laird random effects method, for comparison of CoQ versus PBO (Table). Weighting of studies was inversely according to variance.
|
Parameter |
# pts in analysed trials |
Placebo |
CoQ |
PWMD (95% CI) |
|
EF rest (%) |
29.6±11.0 |
31.4±11.1 |
1.83 (-0.79-4.44) |
|
|
EF exercise (%) |
93 |
26.4±12.3 |
27.6±12.5 |
1.16 (-2.21-4.53) |
|
Max. work capacity (W) |
93 |
156.3±27.9 |
14.6 |
4.90 (-1.71-11.50) |
Therefore, there is a trend for an improvement with CoQ treatment in the outcomes analysed. However, this trend does not reach statistical significance. Based on the available data, there is no definitive evidence of a major beneficial effect of CoQ on cardiac function in pts with CHF.
