Translational Cardiology: Practical Insights into the Coenzyme Q10 Role as Potential Therapeutic Agent for Cardiovascular Disease Treatment via Systematic Review and Meta-Analysis of Prospective Cohort Studies

Abstract

Borges, Julian Y.V.

Background and Objectives: As clinicians seek novel treatment strategies for CVDs, personalized nutrient recommendations are becoming essential. CoQ10, a key component of the mitochondrial electron transport chain, shows promise with proven cardioprotective effects. This systematic review and meta-analysis evaluates the efficacy of CoQ10 supplementation in improving mitochondrial function, systolic performance, and other parameters in CVD.

Methods: Analysis included data from PubMed, Embase, and the Cochrane Library up to January 2024. It focused on randomized controlled trials (RCTs) involving adults with cardiovascular diseases (CVDs), comparing CoQ10 with placebo or standard care. Data extraction and quality assessment followed PRISMA guidelines, the Cochrane Collaboration's RoB2 tool, AMSTAR 2, and GRADE. The primary outcome was mitochondrial function (ATP production, respiratory capacity), and the secondary outcome was systolic function (ejection fraction).

Findings: CoQ10 supplementation improved ejection fraction (mean difference: 5.6%, 95% CI: 3.2% to 8.0%, p<0.001, I2=25%). The I2 statistic for ejection fraction was 25%, indicating low heterogeneity. Mitochondrial function showed increased ATP production (SMD: 0.82, 95% CI: 0.60 to 1.04, p<0.001, I2=30%) and enhanced respiratory capacity (SMD: 0.75, 95% CI: 0.53 to 0.97, p<0.001, I2=28%). The I2 statistics for ATP production and mitochondrial respiratory capacity were 30% and 28%, respectively, suggesting low to moderate heterogeneity. Sensitivity analyses confirmed the robustness of the results, with consistent effect sizes and confidence intervals across both fixed-effect and random-effects models, and no significant changes upon excluding high-risk studies. Publication bias was low, as indicated by funnel plots and Egger's test (p=0.12).

Limitations: Larger-scale RCTs are needed to confirm findings and determine the optimal dosage and duration of CoQ10 therapy.

Conclusion: CoQ10 has been consistently shown to improve mitochondrial function, systolic performance, and other key cardiovascular health parameters in CVD patients. The evidence here presented strongly bridges the gaps between the current research and clinical applications and supports clinicians in implementing the prescription of CoQ10 supplementation as an intervention evidence-based therapeutic agent that effectively improves cardiovascular health outcomes.

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