Coenzyme Q10 supplementation in patients with heart failure: A literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v15i4.50993

Keywords:

Heart failure, Supplementation, Coenzyme Q10, Cardiovascular disease.

Abstract

Coenzyme Q10 (CoQ10), an antioxidant present in foods and synthesized endogenously, has been studied for its benefits on cardiac function. However, further research is needed to validate its recommendation as a non-pharmacological treatment for heart failure (HF). This study aims to conduct a narrative review of the literature from 2018 to 2024, regarding the use of CoQ10 as a supplement for patients with heart failure. A total of 236 articles were initially found, including clinical trials, single-center, and empirical studies on CoQ10 supplementation in HF, while duplicate and unrelated articles were excluded. After screening, four studies were selected for analysis. CoQ10 supplementation ranged from 300 mg/day (100 mg three times daily), 300 mg/day (single dose), up to 600 mg/day, with intervention periods ranging from 30 days to 2 years. Studies using a single daily dose ≥300 mg/day showed more evident benefits, indicating an increase in left ventricular ejection fraction (LVEF) and a reduction in NT-proBNP, improvements in the 6-minute walk test (6MWT), changes in the New York Heart Association (NYHA) functional classification, and a decrease in major adverse cardiovascular events (MACE) in the supplemented groups. Therefore, CoQ10 may be effective as a complementary therapy, helping to improve cardiac function and reduce adverse clinical outcomes in patients with heart failure. However, further studies are needed to consolidate scientific evidence and guide future recommendations in clinical guidelines. 

References

Aaseth, J. et al. (2021). Coenzyme Q10 Supplementation – In Ageing and Disease. Mechanisms of Ageing and Development. 197(15), 111521.

Acosta, M. J. et al. (2016). Coenzyme Q Biosynthesis in Health and Disease. Biochimica et Biophysica Acta (BBA) - Bioenergetics. 1857, 16, 1079–85.

American Heart Association. (2017). Cardiovascular disease: a costly burden for America projections through 2035. Dallas: American Heart Association.

Barcelos, I. P. D. & Haas, R. H. (2019). CoQ10 and Aging. Biology. 8, 28.

Billingsley, H. E. et al. (2020). The Role of Diet and Nutrition in Heart Failure: A State-of-the-Art Narrative Review. Progress in Cardiovasc Dis. 63(5), 538–51.

Brasil. (2018). Agência Nacional de Vigilância Sanitária (ANVISA). Instrução Normativa IN Nº 28, de 26 de julho de 2018. Estabelece listas de constituintes, limites de uso, alegações e rotulagem complementar dos suplementos alimentares. Brasília, DF: ANVISA, p. 1, p. 14, 2018. https://antigo.anvisa.gov.br/documents/10181/3898888/IN_28_2018_COMP.pdf/db9c7460- ae66-4f78-8576-dfd019bc9fa1.

Brasil. (2020). Agência Nacional de Vigilância Sanitária (ANVISA). Resolução - RDC n.º 23, de 15 de março de 2000.

Brasil. (2022). Ministério da Saúde. Doenças cardiovasculares: principal causa de morte no mundo pode ser prevenida. https://www.gov.br/ptbr/noticias/saude-e-vigilancia-sanitaria/2022/09/doencas-cardiovasculares-principal-causa-demorte-no-mundo-pode-ser-prevenida.

Brasil. (2014). Ministério da Saúde. Guia alimentar para a população brasileira. 2. ed. Brasília: Ministério da Saúde. 156. https://bvsms.saude.gov.br/bvs/publicacoes/guia_alimentar_populacao_brasileira_2ed.pdf.

Cirilli, I. et al. (2021). Role of Coenzyme Q10 in Health and Disease: An Update on the Last 10 Years (2010–2020). Antioxidants. 10(8), 1325.

COENZIMA Q10 (CoQ10). (2024). Manual MSD. https://www.msdmanuals.com/pt/casa/assuntos-especiais/suplementos-alimentares-e vitaminas/coenzima-q10-coq10.

Csengo, E. et al. (2024). Newly Initiated Statin Treatment Is Associated with Decreased Plasma Coenzyme Q10 Level After Acute ST-Elevation Myocardial Infarction. International Journal of Molecular Sciences. 26(1), 106.

Driggin, E. et al. (2022). Nutrition Assessment and Dietary Interventions in Heart Failure: JACC Review Topic of the Week. Journal of the American College of Cardiology. 79(16), 1623.

Fernandes, A. D. F. et al. (2020). Insuficiência Cardíaca no Brasil Subdesenvolvido: Análise de Tendência de Dez Anos: Tendência da insuficiência cardíaca no Brasil subdesenvolvido. Arquivos Brasileiros de Cardiologia. 114(2), 222-31. DOI: 10.36660/abc.20180321.

Godinho, A. L. I. (2024). Insuficiência cardíaca entre a alimentação e o exercício físico. Revista Presença. 10(22), 189–208.

Kumar, A. A. et al. (2019). Mitochondrial Dysfunction in Heart Failure With Preserved Ejection Fraction. Circulation. 139(11), 1435–50.

Manicki, M. et al. (2022). Structure and Functionality of a Multimeric Human COQ7:COQ9 Complex. Molecular Cell. 82(22), 4307-23.

Mantle, D. & Dybring, A. (2020). Bioavailability of Coenzyme Q10: An Overview of the Absorption Process and Subsequent Metabolism. Antioxidants. 9(5), 4.

Mantle, D. & Hargreaves, I. (2019). Coenzyme Q10 and Degenerative Disorders Affecting Longevity: An Overview. Antioxidants. 8(2), 386.

Manzar, H. et al. (2020). Cellular Consequences of Coenzyme Q10 Deficiency in Neurodegeneration of the Retina and Brain. International Journal of Molecular Sciences. 21(23), 9299.

Martelli, A. et al. (2020). Coenzyme Q10: Clinical Applications in Cardiovascular Diseases. Antioxidants. 9(4), 341.

Mortensen, A. L. et al. (2019). Effect of coenzyme Q10 in Europeans with chronic heart failure: A sub-group analysis of the Q-SYMBIO randomized double-blind trial. Cardiology Journal, 26(2), 147–56.

Mortensen, S. A. et al. (2014). The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC: Heart Failure. ed. Elsevier inc. 2. 641–9.

Moura, E, K, S et al. (2023). Suplementação nutricional da coenzima q 10: dose terapeutica, custo e benefício. Brazilian Journal of Development. 9(5), 14889–98.

Noh, Y. H. et al. (2013). Inhibition of Oxidative Stress by Coenzyme Q10 Increases Mitochondrial Mass and Improves Bioenergetic Function in Optic Nerve Head Astrocytes. Cell Death & Disease. 4(10), 232640981770777.

Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [free ebook]. Santa Maria. Editora da UFSM.

Pierce, J. D. et al. (2022). Effects of Ubiquinol and/or D-ribose in Patients With Heart Failure With Preserved Ejection Fraction. The American Journal of Cardiology. 176, 79–88.

Rabanal-Ruiz, Y. et al. (2021). The Use of Coenzyme Q10 in Cardiovascular Diseases. Antioxidants. 10(5), 755.

Raizner, A. E. & Quiñones, M. A. (2021). Coenzyme Q10 for Patients With Cardiovascular Disease. Journal of the American College of Cardiology. 77(5), 609–19.

Risemberg, R. I. C., Wakin, M. & Shitsuka, R. (2026). A importância da metodologia científica no desenvolvimento de artigos científicos. Revista E-Acadêmica. 7(1), e0171675. https://doi.org/10.52076/eacad-v7i1.675. https://eacademica.org/eacademica/article/view/675.

Samuel, T. Y. et al. (2022). Coenzyme Q10 in the Treatment of Heart Failure with Preserved Ejection Fraction: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial. Drugs in R&D. 22(1), 25–33.

Sarma, S. et al. (2021). Fortification methods of coenzyme Q10 in yogurt and its health functionality-a review. Frontiers in Bioscience-Scholar. 13(2), 131.

Silva, J, S. et al. (2021). Importância da suplementação com coenzima Q10 no combate aos radicais livres obtidos na atividade física de alta intensidade: uma revisão de literatura. Research, Society and Development. 10(15).

Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, Elsevier. 104(C), 333-9. Doi: 10.1016/j.jbusres.2019.07.039.

Sobirin, M. A. et al. (2019). Effects of coenzyme Q10 supplementation on diastolic function in patients with heart failure with preserved ejection fraction. Drug Discoveries & Therapeutics. 13(1), 38–46.

SOCIEDADE BRASILEIRA DE CARDIOLOGIA (SBC). (2018). Diretriz Brasileira de Insuficiência Cardíaca Crônica e Aguda – 2018. São Paulo: Arquivos Brasileiros de Cardiologia, p. 16. http://publicacoes.cardiol.br/portal/abc/portugues/2018/v11103/pdf/11103021.pdf.

Staiano, C. et al. (2023). Biosynthesis, Deficiency, and Supplementation of Coenzyme Q. Antioxidants. 12(7), 1469.

Suàrez-Rivero, J. M. et al. (2019). Atherosclerosis and Coenzyme Q10. International Journal of Molecular Sciences. 20(20), 5195.

Tippairote, T. et al. (2022). Combined Supplementation of Coenzyme Q10 and Other Nutrients in Specific Medical Condition. Nutrients. 14(20), 4383.

Villalba, J. M. et al. (2010). Therapeutic Use of Coenzyme Q 10 and Coenzyme Q 10 -Related Compounds and Formulations. Expert Opinion on Investigational Drugs. 19(4), 535–54.

Yang, Y. et al. (2015). Coenzyme Q10 Treatment of Cardiovascular Disorders of Ageing Including Heart Failure, Hypertension and Endothelial Dysfunction. Clínica Chimica Acta. 450, 83–9.

Zozina, V, I. et al. (2018). Coenzyme Q10 in Cardiovascular and Metabolic Diseases: Current State of the Problem. Current Cardiololy Reviews. 14(3), 164-74.

Published

2026-04-26

Issue

Section

Review Article

How to Cite

Coenzyme Q10 supplementation in patients with heart failure: A literature review. Research, Society and Development, [S. l.], v. 15, n. 4, p. e9815450993, 2026. DOI: 10.33448/rsd-v15i4.50993. Disponível em: https://www.rsdjournal.org/rsd/article/view/50993. Acesso em: 2 may. 2026.