CoQ10 has quite a few large, favorable, double-blind studies showing benefit for patients with congestive heart failure, heart attack victims, and patients awaiting heart transplant.  Since it is fairly inexpensive at about $12 per month and no significant side-effects, it seems an important part of treatment for these disorders.

Heart Attacks: CoQ10 Considerably Improves Survival in Heart Attacks Treated with Hypothermia: In a DB PC study of 49 heart attack victims, hypothermia plus CoQ10 150 mg t.i.d. had much better 3-month survival (68%) than hypothermia alone (29%) (P=0.0413). Coenzyme Q10 Combined With Mild Hypothermia After Cardiac Arrest. A Preliminary Study. Damian MS, Ellenberg D, et al., University Hospitals of Leicester, United Kingdom. Circulation. 2004 Nov 9;110(19):3011-6

Heart Failure Helped in DB: Coenzyme Q(10) (CoQ(10)) levels decrease in patients with advanced chronic heart failure (CHF). In a DB 4-week per crossover study of 23 patients in NYHA class II and III with stable CHF secondary to ischaemic heart disease, oral CoQ(10) (100 mg tid), CoQ(10) plus supervised exercise training (ET) (60% of peak VO(2), five times a week), placebo, and placebo plus ET were compared. CoQ(10) supplementation resulted in a four-fold increase in plasma CoQ(10) level, whereas the combination with ET further increased it. Oral CoQ(10) improves functional capacity, endothelial function, and LV contractility in CHF without any side effects. The combination of CoQ(10) and ET resulted in higher plasma CoQ(10) levels and more pronounced effects. Coenzyme Q10 and exercise training in chronic heart failure. Belardinelli R, et al. Torrette di Ancona, Italy. . Eur Heart J 2006 Nov;27(22):2675-81.

Heart Failure: CoQ10 Review Very Positive: This Copenhagen University review covers 13 controlled studies of over 1,000 patients and says that 10 of the 13 covering over 900 patients reported positive findings with the other three neutral. A large 550-patient 3 month study of CoQ10 100 mg three times a day has begun with plans for a 2 year follow-up. Overview on coenzyme Q_{10} as adjunctive therapy in chronic heart failure. Rationale, design and end-points of "Q-symbio" - A multinational trial. Mortensen SA. Biofactors. 2003;18(1-4):79-89 

Angina: CoQ10 Helps: In a DB PC study of 12 patients averaging 56 years old who were treated for 4 week with CoQ10 150mg/day there was a decrease in the frequency of angina and the number of nitroglycerin tablets required as well as an increase in exercise tolerance. Kamikawa, Am J Cardiol 8/85;56:247

Large Open Trial Report: In a report of 424 patients with various forms of cardiovascular disease treated by adding coenzyme Q10 to their medical regimens, doses of CoQ10 ranged from 75 to 600 mg/day by mouth (average 242 mg). Treatment was primarily guided by the patient's clinical response. In many instances, CoQ10 levels were employed with the aim of producing a whole blood level greater than or equal to 2.10 micrograms/ml (average 2.92 micrograms/ml, n = 297). Patients were followed for an average of 17.8 months. Of 424 patients, 58 per cent improved by one NYHA class, 28% by two classes and 1.2% by three classes. Improvement occurred in left ventricular wall thickness, mitral valve inflow slope and fractional shortening. During the study, overall medication requirements dropped considerably: 43% stopped between one and three drugs. Only 6% of the patients required the addition of one drug. No apparent side effects from CoQ10 treatment were noted other than a single case of transient nausea. Usefulness of coenzyme Q10 in clinical cardiology: a long-term study. Langsjoen H, Langsjoen P, Langsjoen P, Willis R, Folkers K. University of Texas, Galveston. Mol Aspects Med. 1994;15 Suppl:s165-75

Cardiomyopathy and Progressive Muscular Dystrophies: In a study by an extreme fan of CoQ10 but using a good DB PC format, patients in stage III or IV heart failure were treated for 12 weeks with placebo or CoQ10 and then crossed over to the other treatment. The author says there was tremendous benefit. Langsjoen & Folkers, Proc Natl Acad Sci ’85:82:4240. Q10 is present in normal myocardium for electron transfer and phosphorylation in the mitochondria. At 82:4513 Folker says 12 patients with 6 different progressive muscular dystrophy were helped.

Heart Attacks Cut in Half; Fatigue Markedly Reduced:  In a DB PC study of 144 heart attack patients started on 120 mg/day of CoQ10 within 3 days of the heart attack, large decreases in angina (10% vs. 28%), total arrhythmias (10% vs. 25%), poor left ventricular functioning (8% vs. 22%) and total cardiac events (15% vs. 31%) occurred over the next 28 days. After 1 year, total cardiac events (24.6 vs. 45.0%, p < 0.02) including non-fatal infarction (13.7 vs. 25.3%, p < 0.05) were much less with CoQ10. Lipid peroxidases, malondialdehyde, and diene conjugates, all indicators of oxidative stress, were lower with Q10. Vitamins A, C, E, and beta-carotene were all higher with Q10. Singh, Moradabad, Cardiovasc Drug Ther 9/1998;12:347; In another study, fatigue was markedly decreased: 7% vs. 40% Mol Cell Biochem. 2003 Apr;246(1-2):75-82

Congestive Heart Failure: CoQ10 Not Help in Very Small Study but Taurine Did: In a DB study, taurine 3g/day was compared to CoQ10 in 17 patients with CHF for 6 weeks. There was no benefit from Q10 but better left ventricular heart function with taurine. Azuma, Osaka U, Jpn Circ J ’92;56:95

CHF: CoQ10 Not Much Help: The Swedish Q10 Study Group using a DB PC trial of 79 patients with half given CoQ10 100 mg/day for 3 months found only minimally improved quality of life and exercise tolerance. Hofman-Bang, Karolinska Inst, J Card Fail 3/95;1:101

Heart Transplant: CoQ10 Helped Patients Waiting: In a DB PC study of 32 patients awaiting heart transplants, 60 mg U/day of CoQ10 (a special preparation to increase intestinal absorption) for 3 months led to significant improvement in the 6-min walk test and a decrease in dyspnea, New York Heart Association (NYHA) classification, nocturia, and fatigue. No significant changes were noted after 3 months of treatment in echocardiography parameters (dimensions and contractility of cardiac chambers) or ANF and TNF blood levels. Coenzyme Q10 in patients with end-stage heart failure awaiting cardiac transplantation: a randomized, placebo-controlled study. Berman M, Erman A, Ben-Gal T, Dvir D, Georghiou GP, Stamler A, Vered Y, Vidne BA, Aravot D. Rabin Medical Center, Israel. Clin Cardiol. 2004 May;27(5):295-9.

Heart Failure Awaiting Transplant: CoQ10 ? Helps: Folker of U Texas Austin says 11 patients were treated and all dramatically improved, some getting off all other med. Biochem Biophys Res Commun ‘92;182:247

Heart Failure in Very Large DB: CoQ10 Helps: A large Italian 1 year DB PC study of 640 patients in stage III or IV congestive heart failure had CoQ10 2 mg/kg/d added to their regular medication or were given a placebo. The CoQ10 group had fewer hospitalizations (73 vs. 118), less cardiac asthma (97 vs. 198), and less pulmonary edema (20 vs. 53). Morisco, Clin Investig ’93;71(8 Suppl);S134. Ed: This large of a study is excellent and the benefits appear quite impressive.

Cardiomyopathies (Dilative): CoQ10 No Help: In a 4-month 25 patient DB PC crossover study of CoQ10 in patients with stages 1, 2, or 3 heart disease, no benefit was found. Permanetter, Z Kardiol ’89:78:360. Ed: In such a small study, clinical worthwhile effects are often difficult to detect.