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2013 心臟故障医學會議

Coenzyme Q10 decreases all cause mortality by half, according to the results of a multicentre randomised double blind trial presented today at Heart Failure 2013 congress. It is the first drug to improve heart failure mortality in over a decade and should be added to standard treatment, according to lead author Professor Svend Aage Mortensen (Copenhagen, Denmark).

Heart Failure 2013 is being held from 25-28 May in Lisbon, Portugal. It is the main annual meeting of the Heart Failure Association of the European Society of Cardiology.

Coenzyme Q10 (CoQ10) occurs naturally in the body and is essential to survival. CoQ10 works as an electron carrier in the mitochondria, the powerhouse of the cells, to produce energy and is also a powerful antioxidant. It is the only antioxidant that humans synthesise in the body.

 

CoQ10 levels are decreased in the heart muscle of patients with heart failure, with the deficiency becoming more pronounced as heart failure severity worsens. Statins are used to treat many patients with heart failure because they block the synthesis of cholesterol, but these drugs also block the synthesis of CoQ10, which further decreases levels in the body.

Double blind controlled trials have shown that CoQ10 improves symptoms, functional capacity and quality of life in patients with heart failure with no side effects. But until now, no trials have been statistically powered to address effects on survival.

The Q-SYMBIO study randomised 420 patients with severe heart failure (New York Heart Association (NYHA) Class III or IV) to CoQ10 or placebo and followed them for 2 years. The primary endpoint was time to first major adverse cardiovascular event (MACE) which included unplanned hospitalisation due to worsening of heart failure, cardiovascular death, urgent cardiac transplantation and mechanical circulatory support. Participating centres were in Denmark, Sweden, Austria, Slovakia, Poland, Hungary, India, Malaysia and Australia.

CoQ10 halved the risk of MACE, with 29 (14%) patients in the CoQ10 group reaching the primary endpoint compared to 55 (25%) patients in the placebo group (hazard>

CoQ10 treated patients had significantly lower cardiovascular mortality

Professor Mortensen said: "CoQ10 is the first medication to improve survival in chronic heart failure since ACE inhibitors and beta blockers more than a decade ago and should be added to standard heart failure therapy."

He added: "Other heart failure medications block rather than enhance cellular processes and may have side effects. Supplementation with CoQ10, which is a natural and safe substance, corrects a deficiency in the body and blocks the vicious metabolic cycle in chronic heart failure called the energy starved heart."

CoQ10 is present in food, including red meat, plants and fish, but levels are insufficient to impact on heart failure. CoQ10 is also sold over the counter as a food supplement but Professor Mortensen said: "Food supplements can influence the effect of other medications including anticoagulants and patients should seek advice from their doctor before taking them."

Source: European Society of Cardiology
Posted in: Medical Research News | Medical Condition News
https://www.news-medical.net/news/20130527/Coenzyme-Q10-decreases-all-cause-mortality-by-half-in-randomized-double-blind-trial.aspx

 

根據2013年心力衰竭大會今天提出的多中心隨機雙盲試驗的結果，輔酶Q10將所有原因死亡率降低一半。根據主要作者Svend Aage Mortensen教授（丹麥哥本哈根），這是十多年來首例改善心力衰竭死亡率的藥物，應加入標準治療。

心臟衰竭2013年5月25日至28日在葡萄牙里斯本舉行。它是歐洲心臟病學會心力衰竭協會的主要年會。

輔酶Q10（CoQ10）自然發生在體內，對生存至關重要。 CoQ10在線粒體內的電力中心，細胞的力量，產生能量，也是一種強大的抗氧化劑。它是人類在體內合成的唯一抗氧化劑。

心力衰竭患者的心肌CoQ10水平降低，隨著心力衰竭嚴重程度惡化，缺血情況變得更加明顯。他汀類藥物用於治療許多心力衰竭患者，因為它們阻斷膽固醇的合成，但是這些藥物也阻斷CoQ10的合成，這進一步降低了身體的水平。

雙盲對照試驗顯示，CoQ10可改善心力衰竭患者的症狀，功能能力和生活質量，無副作用。但到目前為止，還沒有統計上的試驗來解決對生存的影響。

Q-SYMBIO研究將420例嚴重心力衰竭患者（紐約心臟協會（NYHA）III級或IV級）隨機分配到CoQ10或安慰劑，並隨訪2年。主要終點是第一次主要不良心血管事件（MACE）的時間，包括因心力衰竭惡化，心血管死亡，緊急心臟移植和機械循環支持而導致的意外住院治療。參加中心分別在丹麥，瑞典，奧地利，斯洛伐克，波蘭，匈牙利，印度，馬來西亞和澳大利亞。

CoQ10將MACE風險降低一半，CoQ10組中29例（14％）患者達到主要終點，而安慰劑組為55例（25％）（危險）. CoQ10治療的患者心血管死亡率明顯降低Mortensen教授說：十多年前ACE抑製劑和β阻滯劑在慢性心力衰竭中的首選藥物，現在CoQ10應加入標準心力衰竭治療中。”

他補充說：“其他心力衰竭藥物阻斷而不是增強細胞過程，並可能產生副作用。補充CoQ10是一種天然和安全的物質，可糾正身體的缺陷，阻止慢性心力衰竭中的惡性代謝循環，稱為能量餓死的心.

CoQ10存在於食物中，包括紅肉，植物和魚類，但水平不足以幫助心力衰竭。 CoQ10也作為食品補充劑出售在櫃檯上，但Mortensen教授說：“食品添加劑可以影響其他藥物（包括抗凝劑）的效果，患者在服用前應諮詢醫生的意見。”

資料來源：歐洲心臟病學會

發表在：醫學研究新聞| 醫療狀況新聞

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