Coenzyme Q10 levels are low and associated with increased mortality in post-cardiac arrest patients.


2015-02-17 16:43:45

AIM:Survival after cardiac arrest (CA) is limited by the profound neurologic insult from ischemia-reperfusion injury. Therapeutic options are limited. Previous data suggest a benefit of coenzyme Q(10) (CoQ(10)) in post-arrest patients. We hypothesized that plasma CoQ(10) levels would be low after CA and associated with poorer outcomes.

METHODS: Prospective observational study of post-arrest patients presenting to a tertiary care center. CoQ(10) levels were drawn 24h after return of spontaneous circulation (ROSC) and compared to healthy controls. Levels of inflammatory cytokines and biomarkers were analyzed. Primary endpoints were survival to discharge and neurologic status at time of discharge.

RESULTS:23 CA subjects and 16 healthy controls were enrolled. CoQ(10) levels in CA patients (0.28 őľmol L(-1), inter-quartile range (IQR): 0.22-0.39) were significantly lower than in controls (0.75 őľmol L(-1), IQR: 0.61-1.08, p<0.0001). The mean CoQ(10) level in CA patients who died was significantly lower than in those who survived (0.27 vs 0.47 őľmol L(-1), p = 0.007). There was a significant difference in median CoQ(10) level between patients with a good vs poor neurological outcome (0.49 őľmol L(-1), IQR: 0.30-0.67 vs 0.27 őľmol L(-1), IQR: 0.21-0.30, p = 0.02). CoQ(10) was a statistically significant predictor of poor neurologic outcome (adjusted p = 0.02) and in-hospital mortality (adjusted p = 0.026).

CONCLUSION:CoQ(10) levels are low in human subjects with ROSC after cardiac arrest as compared to healthy controls. CoQ(10) levels were lower in those who died, as well as in those with a poor neurologic outcome.

Functional benefits of PLGA particulates carrying VEGF and CoQ10 in an animal of myocardial ischemia.


2015-02-17 16:34:43

Myocardial ischemia (MI) remains one of the leading causes of death worldwide. Angiogenic therapy with the vascular endothelial growth factor (VEGF) is a promising strategy to overcome hypoxia and its consequences. However, from the clinical data it is clear that fulfillment of the potential of VEGF warrants a better delivery strategy. On the other hand, the compelling evidences of the role of oxidative stress in diseases like MI encourage the use of antioxidant agents. Coenzyme Q10 (CoQ10) due to its role in the electron transport chain in the mitochondria seems to be a good candidate to manage MI but is associated with poor biopharmaceutical properties seeking better delivery approaches. The female Sprague Dawley rats were induced MI and were followed up with VEGF microparticles intramyocardially and CoQ10 nanoparticles orally or their combination with appropriate controls. Cardiac function was assessed by measuring ejection fraction before and after three months of therapy. Results demonstrate significant improvement in the ejection fraction after three months with both treatment forms individually; however the combination therapy failed to offer any synergism. In conclusion, VEGF microparticles and CoQ10 nanoparticles can be considered as promising strategies for managing MI.

Myocardial protection during elective coronary artery bypasses grafting by pretreatment with omega-3 polyunsaturated fatty acids.


2015-02-17 15:00:17


Despite recent advances in coronary artery bypass grafting (CABG), cardioplegic cardiac arrest and cardiopulmonary bypass (CPB) are still associated with myocardial injury. Accordingly, the efforts have been made lately to improve the outcome of CPB by glucose-insulin-potassium, adenosine, Ca(2+)-channel antagonists, L-arginine, N-acetylcysteine, coenzyme Q10, diazoxide, Na+/H+ exchange inhibitors, but with an unequal results. Since omega-3 polyunsatutated fatty acids (PUFAs) have shown remarkable cardioprotection in preclinical researches, the aim of our study was to check their effects in prevention of ischemia reperfusion injury in patients with CPB.


This prospective, randomized, placebo-controlled study was performed with parallel groups. The patients undergoing elective CABG were randomized to receive preoperative intravenous omega-3 PUFAs infusion (n = 20) or the same volume of 0.9% saline solution infusion (n = 20). Blood samples were collected simultaneously from the radial artery and the coronary sinus before starting CPB and at 10, 20 and 30 min after the release of the aortic cross clamp. Lactate extraction/excretion and myocardial oxygen extraction were calculated and compared between the two groups. The levels of troponin I (TnT) and creatine kinase-myocardial band (CK-MB) were determined before starting CPB and 4 and 24 h postoperatively.


Demographic and operative characteristics, including CPB and aortic cross-clamp time, were similar between the two groups of patients. The level of lactate extraction 10 and 20 min after aortic cross-clamp time has shown negative values in the control group, but positive values in the PUFAs group with statistically significant differences (-19.6% vs 7.9%; p < 0.0001 and -19.9% vs 8.2%; p < 0.0008, respectively). The level of lactate extraction 30 minutes after reperfusion was not statistically different between the two groups (6.9% vs 4.2%; p < 0.54). Oxygen extraction in the PUFAs group was statistically significantly higher compared to the control group after 10, 20 and 30 min of reperfusion (35.5% vs 50.4%, p < 0.0004; 25.8 % vs 48.7%, p < 0.0001 and 25.8% vs 45.6%, p < 0.0002, respectively). The level of TnT, 4 and 24 h after CPB, was significantly higher in the control group compared to PUFAs group, with statistically significant differences (11.4 vs 6.6, p < 0.009 and 12.7 vs 5.9, p < 0.008, respectively). The level of CK-MB, 4 h after CPB, was significantly higher in the control group compared to PUFAs group (61.9 vs 37.7, p < 0.008), but its level, 24 h after CPB, was not statistically different between the two groups (58.9 vs 40.6, p < 0.051).


Treatment with omega-3 PUFAs administered preoperatively promoted early metabolic recovery of the heart after elective CABG and improved myocardial protection. This study showed that omega-3 emulsion should not be considered only as a nutritional supplement but also as a clinically safe and potent cardioprotective adjunct during CPB.

A Coenzyme Q10 szintje alacsony, √©s ez √∂sszef√ľgg√©sbe hozhat√≥ a sz√≠vle√°ll√°s ut√°ni elhal√°loz√°s megn√∂vekedett ar√°ny√°val a p√°ciensekn√©l.


2015-02-17 16:43:45

Cocchi MN1, Giberson B, Berg K, Salciccioli JD, Naini A, Buettner C, Akuthota P, Gautam S, Donnino MW.

  • 1Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States. S√ľrgŇĎss√©gi Orvosl√°si Oszt√°ly, Beth Israel DeaconessOrvosi K√∂zpont, Boston, MA 02215, Egyes√ľlt √Āllamok.



A sz√≠vle√°ll√°s (CA) ut√°ni t√ļl√©l√©s korl√°tozott lehetŇĎs√©get mutat, mivel m√©lys√©ges neurol√≥giai s√©r√ľl√©sek k√∂vetkeznek be az ischemi√°s √ļjrakeringet√©ses s√©r√ľl√©sek k√∂vetkezt√©ben. A ter√°pi√°s v√°laszt√°si lehetŇĎs√©gek korl√°tozottak. Kor√°bbi adatok azt sugallj√°k, hogy a coenzyme Q(10) (CoQ(10)) j√≥t√©kony hat√°st gyakorol a sz√≠vle√°ll√°st elszenvedett p√°ciensekre. Mi elŇĎzetesen azt felt√©telezt√ľk, hogy a plazma coenzyme Q(10) szintje alacsony lehet sz√≠vle√°ll√°s (CA) ut√°n, √©s ez lehet √∂sszef√ľgg√©sben a gyenge eredm√©nyekkel.


ElŇĎre eltervezett megfigyel√©ses k√≠s√©rlet olyan sz√≠vle√°ll√°st elszenvedett p√°ciensek bevon√°s√°val, akik egy harmadik kezelŇĎ k√∂zpontban jelentkeztek. A coenzyme Q(10) szintj√©t 24 √≥r√°val a spont√°n kering√©s (ROSC) vissza√°ll√°sa ut√°n m√©rt√ľk, majd √∂sszehasonl√≠tottuk eg√©szs√©ges kontrollszem√©lyek√©vel. A gyullad√°skeltŇĎ citokineket √©s biomarkereket elemezt√ľk.  Az elsŇĎdleges szempontok a t√ļl√©l√©si ar√°ny elbocs√°t√°skor, valamint a neurol√≥giai √°llapotuk a k√≥rh√°zb√≥l val√≥ elbocs√°t√°skor.


23 CA k√≠s√©rleti alanyt √©s 16 eg√©szs√©ges kontrollszem√©lyt vett√ľnk fel. A CoQ(10) szintje a CA p√°ciensek eset√©ben (0.28 őľmol L(-1), inter-quartile (n√©gysz√∂gfok√ļ) sk√°l√°n (IQR): 0.22-0.39) jelentŇĎsen alacsonyabb volt, mint a kontrollszem√©lyek eset√©ben (0.75 őľmol L(-1), IQR: 0.61-1.08, p<0.0001). Az √°tlagos CoQ(10) szintje azokn√°l a CA p√°ciensekn√©l, akik elhal√°loztak, jelentŇĎsen alacsonyabb volt, mint azokn√°l, akik t√ļl√©lt√©k a sz√≠vle√°ll√°st (0.27 kontra 0.47 őľmol L(-1), p = 0.007). JelentŇĎs k√ľl√∂nbs√©g volt a k√∂z√©p√©rt√©kŇĪ CoQ(10) szintj√©ben azoknak a p√°cienseknek az eset√©ben, akiknek ez az eredm√©nye j√≥ volt, szemben a gyenge neurol√≥giai eredm√©nyeket mutat√≥kkal (0.49 őľmol L(-1), IQR: 0.30-0.67 kontra 0.27 őľmol L(-1), IQR: 0.21-0.30, p = 0.02). A CoQ(10) statisztikaliag jelentŇĎs elŇĎjele volt a gyenge neurol√≥giai eredm√©nynek (be√°ll√≠tott √©rt√©k p = 0.02) √©s a k√≥rh√°zban val√≥ elhal√°loz√°s (be√°ll√≠tott √©rt√©k p = 0.026).



A CoQ(10) szintje azokn√°l a ROSC k√≠s√©rleti emberalanyokn√°l, akik sz√≠vle√°ll√°st szenvedtek, √∂sszehasonl√≠tva az eg√©szs√©ges kontrollszem√©lyek CoQ(10) szintj√©vel.  A CoQ(10)  szintje alacsonyabb volt az elhal√°lozottak eset√©ben, valamint azoknak a p√°ciensek eset√©ben is, akik gyenge neurol√≥giai eredm√©nyt mutattak.

A PLG VEGF-et és CoQ10-et hordozó részecskéinek funkcionális hasznossága az állatok szívizomzati ischemiájában.


2015-02-17 16:34:43

Simón-Yarza T1, Tamayo E, Benavides C, Lana H, Formiga FR, Grama CN, Ortiz-de-Solorzano C, Kumar MNProsper FBlanco-Prieto MJ

Inform√°ci√≥k a szerzŇĎrŇĎl

  • 1Gy√≥gyszer√©szeti √©s Gy√≥gyszer√©szeti Technol√≥giai Szak, Gy√≥gyszer√©szeti Iskola, Navarrai Egyetem, Pamplona, Spanyolorsz√°g.


Vil√°gszerte a sz√≠vizomzati ischemia (MI) marad a vezetŇĎ hal√°lok. Az angiog√©n (√©r eredetŇĪ) ter√°pia vaszkul√°ris (v√©red√©ny-) belh√°m n√∂veked√©si faktor (VEGF) egy √≠g√©retes strat√©gia, hogy le lehessen gyŇĎzni a hypoxi√°t (oxig√©nhi√°ny) √©s annak k√∂vetkezm√©nyeit. A klinikai adatokb√≥l azonban vil√°gos, hogy a lehets√©ges VEGF elv√©gz√©se jobb kivitelez√©si strat√©gi√°t tud biztos√≠tani. M√°sr√©szt az oxidat√≠v stressz k√©nyszer√≠tŇĎ bizony√≠t√©kai az olyan betegs√©gekben, mint az MI, arra b√°tor√≠tanak, hogy antioxid√°ns hat√≥anyagokat haszn√°ljunk. A Coenzyme Q10 (CoQ10) szerep√©n√©l fogva, mellyel r√©szt vesz az elektrontov√°bb√≠t√≥ l√°ncban a mitokondriumban, j√≥ jel√∂ltnek tŇĪnik, hogy fel√ľgyelje az MI-t, b√°r gyenge bio-gy√≥gyszer√©szeti tulajdons√°gokkal b√≠r, √©s jobb k√∂zvet√≠tŇĎi megk√∂zel√≠t√©st kell keresni hozz√°. A Sprague Dawley nŇĎst√©ny patk√°nyokn√°l MI-t ind√≠tottak be, amit VEGF mikror√©szecsk√©s kezel√©s k√∂vetett miokardi√°lisan (a sz√≠vizomba adva), majd CoQ10 nano-r√©szecsk√©ket kaptak sz√°jon kereszt√ľl, vagy pedig ezek kombin√°ci√≥j√°t a megfelelŇĎ kontroll alatt. Sz√≠vfunkci√≥jukat begyŇĪjt√∂tt√©k a kivet√©si frakci√≥ m√©r√©s√©vel, h√°rom h√≥nappal a ter√°pia elŇĎtt √©s ut√°n. Az eredm√©nyek azt mutatj√°k, hogy jelentŇĎs javul√°s mutatkozott a frakci√≥ kidob√°s√°ban h√°rom h√≥nappal mindk√©t fajta kezel√©s ut√°n h√°rom h√≥nappal, egy√©nileg; √°m a kombin√°lt gy√≥gym√≥d sikertelen volt b√°rmif√©le szinergikus (k√∂lcs√∂n√∂s) lehetŇĎs√©g ny√ļjt√°s√°ban. K√∂vetkez√©sk√©ppen a VEGF mikro-r√©szecsk√©ket √©s a CoQ10 nano-r√©szecsk√©ket √≠g√©retes strat√©gi√°nak lehet tekinteni az MI kezel√©s√©ben.


Download image: Right click, "Image save as..."