Coenzyme Q10 Terclatrate and Creatine in Chronic Heart Failure: A Randomized, Placebo-Controlled, Double-Blind Study

Background: Studies have suggested that micronutrient deficiency has some role in the progression of chronic heart failure (CHF). Hypothesis: Oral supplementation with coenzyme Q(10) (CoQ(10)) and creatine may reduce mitochondrial dysfunction that contributes to impaired physical performance in CHF. Methods: We conducted a randomized, double-blind, placebo-controlled trial to determine the effect of a mixture of water-soluble CoQ(10) (CoQ(10) terclatrate; Q-ter) and creatine on exercise tolerance and health-related quality of life. Exercise tolerance was measured as total work capacity (kg.m) and peak oxygen consumption (VO2, mL/min/kg), both from a cardiopulmonary exercise test. Health-related quality of life was measured by the Sickness Impact Profile (SIP) in CHF secondary to left ventricular systolic dysfunction (left ventricular ejection fraction <= 35%). After baseline assessment, 67 patients with stable CHF were randomized to receive Q-ter 320 mg + creatine 340 mg (n=35) or placebo (n=32) once daily for 8 weeks. Results: At multivariate analysis, 8-week peak VO2 was significantly higher in the active treatment group than in the placebo group (+1.8 +/- 0.9 mL/min/kg, 95% CI: 0.1-3.6, P < 0.05). No untoward effects occurred in either group. Conclusions: This study suggests that oral Q-ter and creatine, added to conventional drug therapy, exert some beneficial effect on physical performance in stable systolic CHF. Results may support the design of larger studies aimed at assessing the long-term effects of this treatment on functional status and harder outcomes.