ORIGINAL RESEARCH & CONTRIBUTIONS
Statin-Associated Cardiomyopathy Responds to Statin Withdrawal and Administration of Coenzyme Q10
Peter H Langsjoen, MD, FACC1 ; Jens O Langsjoen, MD2 ; Alena M Langsjoen, MS1 ; Franklin Rosenfeldt, MD, FRACS3,4 Perm J 2019;23:18.257 E-pub: 08/26/2019 https://doi.org/10.7812/TPP/18.257
ABSTRACT Context: Heart failure (HF) is rapidly increasing in incidence and is often present in patients receiving long-term statin therapy.
Objective: To test whether or not patients with HF on long-term statin therapy respond to discontinuation of statin therapy and initiation of coenzyme Q10 (CoQ10) supplementation.
Design: We prospectively identified patients receiving long-term statin therapy in whom HF developed in the absence of any identifiable cause. Treatment consisted of simultaneous statin therapy discontinuation and CoQ10 supplementation (average dosage = 300 mg/d).
Main Outcome Measures: Baseline and follow-up physical examination findings, symptom scores, echocardiograms, and plasma CoQ10 and cholesterol levels.
Results: Of 142 identified patients with HF, 94% presented with preserved ejection fraction (EF) and 6% presented with reduced EF (< 50%). After a mean follow-up of 2.8 years, New York Heart Association class 1 increased from 8% to 79% (p < 0.0001). In patients with preserved EF, 34% had normalization of diastolic function and 25% showed improvement (p < 0.0001).
In patients with reduced EF at baseline, the EF improved from a mean of 35% to 47% (p = 0.02).
Statin-attributable symptoms including fatigue, muscle weakness, myalgias, memory loss, and peripheral neuropathy improved (p < 0.01).
The 1-year mortality was 0%, and the 3-year mortality was 3%.
Conclusion: In patients receiving long-term statin therapy, statin-associated cardiomyopathy may develop that responds safely to statin treatment discontinuation and CoQ10 supplementation
My comment: Apparently the administration of Co-enzyme Q10 on its own without statin discontinuation rarely works to restore cardiac function on its own in heart failure patients. This is discussed in the article. Co-enzyme Q10 is also helpful for gum disease which affects people with diabetes a lot.