Cardiac Surgery

The use of CoQ10 supplementation before cardiac surgery has been studied since the early 1980s. Since that time, growing evidence suggests that CoQ10 can reduce reperfusion injury after coronary artery bypass surgery, reduce surgical complications, accelerate recovery times and possibly shorten hospital stays (Chello et al 1996, Chen et al 1994, Judy et al 1993, Rosenfeldt et al 2002, Taggart et al 1996, Tanaka et al 1982, Zhou et al 1999). In general, the studies that achieved positive results had provided supplements for 1-2 weeks prior to surgery.

One study observed that continuing to administer CoQ10 for 30 days after surgery hastened the recovery course to 3-5 days without complications, compared with a 1 5-30-day recovery period for a control group, which did experience complications (Judy et al 1993, Rosenfeldt et al 2002).

The most recent randomised, double-blind trial investigated the effects of preoperative high-dose CoQ10 therapy (300 mg/day) in patients undergoing elective cardiac surgery (mainly coronary artery bypass graft surgery or valve replacement) (Rosenfeldt et al 2005). Approximately 2 weeks of active treatment resulted in significantly increased CoQ10 levels in the serum, atrial myocardium and mitochondria compared with placebo, but no significant change in the duration of hospital stay. Active treatment also improved subjective assessment of physical QOL (+13%) compared with placebo; however, the authors point out that physical QOL does not necessarily indicate improved cardiac pump function and further studies are required with larger sample sizes to clarify the role of CoQ10 in cardiac surgery.

The use of CoQ10 as preoperative treatment may hold special significance for older patients, who generally experience poorer recovery of cardiac function after cardiac surgery than their younger counterparts. One explanation gaining support is that the aged myocardium has less homeostatic reserve and so is more sensitive to both aerobic and physical stress and less well equipped to deal with cardiac surgery. Two studies have confirmed this theory, demonstrating an age-related deficit in myocardial performance after aerobic and ischaemic stress and the capacity of CoQ10 treatment to correct age-specific diminished recovery of function (Rosenfeldt et al 1999).

Besides improving cardiac resilience, CoQ10 has been found to reduce skeletal muscle reperfusion injury after clamping and declamping by reducing the degree of peroxidative damage (Chello et al 1996).

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