Efficacy and safety of coenzyme Q10 in heart failure: a meta-analysis of randomized controlled trials.

Background: The effectiveness and adverse effects of coenzyme Q10 for heart failure remain unclear owing to small sample sizes and variations in the quality of existing studies in literature.

Methods: The databases of EMBASE, PubMed, Web of Science, CINAHL databases, Scopus, Cochrane Central Register of Controlled Trials, VIP, Wanfang, and CNKI were searched for randomized controlled trials on the coenzyme Q10-assisted treatment of heart failure. Relevant literature was retrieved, data were extracted, and the risk of bias of the included studies was evaluated by two investigators independently using the Review Manager 5.4 software and the STATA 15 software.

Results: In total, 33 studies were included in this meta-analysis, which showed that all-cause mortality [RR = 0.64, 95% CI (0.48, 0.85), P = 0.002; GRADE: moderate quality], hospitalization for heart failure [RR = 0.50, 95% CI (0.37, 0.67), P < 0.00001; GRADE: moderate quality], New York Heart Association classification [MD = - 0.29, 95% CI (- 0.39, - 0.19), P < 0.00001; GRADE: low quality], and brain natriuretic peptide level [MD = - 91.97, 95% CI (- 103.11, - 80.83), P < 0.00001; GRADE: low quality] were lower in the coenzyme Q10 group than in the control group. Meanwhile, left ventricular ejection fraction [MD = 0.51, 95% CI (0.31, 0.71), P < 0.00001; GRADE: low quality] and 6-min walk test result [MD = 31.70, 95% CI (19.96, 43.43), P < 0.00001; GRADE: moderate quality] were better than those in the control group.

Conclusions: According to the existing evidence, coenzyme Q10 reduces all-cause mortality, hospitalization for heart failure, New York Heart Association classification, and brain natriuretic peptide level and improves left ventricular ejection fraction and 6-min walk test result in those with heart failure without major adverse effects.

Trial Registration: This study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, http://www.crd.york.ac.uk/prospero ), with the registration number CRD42023493184.