Cardioprotective Effects of Coenzyme Q10 Supplementation on Patients with ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract

Background: We assessed the potential efficacy of Coenzyme Q10 (CoQ10) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Methods: Seventy STEMI patients who presented ≤12 hours after the onset of symptoms and were scheduled for PPCI were randomly assigned to the standard treatments plus CoQ10 or placebo. In the intervention group, CoQ10, as an oral capsule at a dose of 400 mg, was loaded immediately before PPCI and continued at 200 mg twice daily for 28 days. The control group received a matching placebo, similarly. The study endpoints were the proportion of patients with complete myocardial reperfusion, defined as thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade (MBG) 3 at the end of PPCI, the proportion of patients with complete ST-segment elevation resolution (≥70%) assessed 60 minutes after PPCI, the plasma levels of creatine kinase myocardial band isoenzyme (CK-MB) and troponin I (TnI) at 12, 24, 48, and 72 hours after PPCI, and left ventricular ejection fraction (LVEF) at day 28. Results: The study groups were comparable regarding baseline clinical and procedural characteristics. The proportion of patients with TIMI flow grade 3, MBG 3, and complete ST resolution after completion of PPCI was similar between the groups. Whereas at all-time points after PPCI (12, 24, 48, and 72 hours), the plasma levels of CK-MB and TnI were significantly lower in the CoQ10 group than in the control group. Further, at day 28, CoQ10-treated patients exhibited better LVEF than placebo-treated patients, and the proportion of patients with LVEF less than 50% was lower in the intervention group than in the control group. Conclusion: Our study provided evidence that CoQ10 supplementation might reduce myocardial ischemia-reperfusion injury after PPCI and help to preserve left ventricular function. However, further studies are required to validate these results.