Adjuvant Coenzyme Q10 in the treatment of heart failure

How common is heart failure in Hungary?

It affects 2% of the population, therefore it is a significant malignant disease, and in many cases it exceeds the mortality of different cancerous diseases. Systolic heart failure is associated with reduced ejection fraction (HFrEF), whereas diastolic heart failure is often caused by neglected hypertension in the elderly. Mortality depends on the stage of the disease. If heart failure is diagnosed late, the mortality is 10-20% even with optimal treatment. If it is diagnosed in early stage, mortality is less than 10%.

What are the therapeutic options in different types of heart failure?

The therapy of diastolic form is mostly empiric, whereas the adequate therapy of systolic heart failure is based on evidences and established protocol. In the latter case, giving Coenzyme Q10 to the patients as an adjuvant therapy is required.

What is the mechanism of action of Coenzyme Q10?

Coenzyme Q10 is a vitamin-like substance, which has an oxidative effect, and also produced by the human body. It accelerates the terminal oxidation, takes part in the anaerobic respiration and helps the heart muscle to function by producing energy in ATP. With its continuous administration, it replenishes energy stores, and in case of heart failure it exerts its effect where needed. It is the only “vitamin”, in which I believe as a cardiologist.

There were numerous clinical trials on PharmaNord’s medical quality Coenzyme Q10 product. What are the experiences?

The adjuvant therapy of chronic systolic heart failure is the main indication for the use of this product, and empirical evidences confirm the role of Coenzyme Q10 in reducing muscle pain caused by statin treatment. The latter has a great importance, since lipid-lowering therapy is very common in Hungary, and can decrease the level of Coenzyme Q10. Meta-analyzes confirm that Myoqinon, used as an adjuvant therapy for muscle pain caused by cholesterol-lowering formulations, significantly reduces undesirable symptoms. Clinical trials confirmed that adjuvant Q10 therapy can improve left ventricular function, survival, and cardiovascular mortality in systolic heart failure. Hospitalization due to heart failure was reduced by almost 40%. Recently, there are ongoing studies on the effects of Q10 on post-Covid patients, who are difficult to mobilize due to energy deficiency, but only empirical data available so far.

To what extent do cardiologists use coenzyme Q10 as adjunctive therapy in Hungary?

I do not know the exact data. We often use it in the Department of Cardiology in Debrecen. Although, it could be used in other fields.  Worth a try in all patients with HFrEF, especially in cases of slow response to basic therapy. 

Are there lot of over-the-counter Q10 products in the market? Are they also effective?

I do not believe in these products. We use high purified, tested pharmaceuticals, in a formulation which can bind and absorb easily; this ensures effective treatment. Furthermore, patients appreciate prescription-only-medicines, they think about it as a medication.

What are the side effects of Myoqinon?

This medication has an excellent side-effect profile, undesirable symptoms have not been reported during the administration of the recommended 200-300 mg daily dose. In case of overdose it might cause diarrhea, but no serious side effects have been reported, so we have nothing to lose with this product.

Why could the product make a breakthrough in the treatment of heart failure?

Several other formulations and vitamins have been tried to use as an adjuvant in the treatment of systolic heart failure, however, most clinical trials have been ended without convincing results.