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(Circulation. 2004;110:3011-3016.)
© 2004 American Heart Association, Inc.

Arrhythmia/Electrophysiology

Coenzyme Q10 Combined With Mild Hypothermia After Cardiac Arrest

A Preliminary Study

Maxwell Simon Damian, MD, PhD; Diana Ellenberg, MD; Ramona Gildemeister, MD; Jörg Lauermann, MD; Gregor Simonis, MD; Wolfgang Sauter, MD; Christian Georgi, MD

From the Department of Neurology, University Hospitals of Leicester, Leicester, United Kingdom (M.S.D.); and the Departments of Neurology (D.E., R.G., W.S.), Internal Medicine/Cardiology (J.L., G.S.), and Cardiothoracic Surgery (C.G.), University of Technology, Dresden, Germany.

Correspondence to Maxwell Damian, MD, PhD, Leicester Royal Infirmary, Infirmary Square, Leicester LE15WW, Leicester, UK. E-mail msd13{at}le.ac.uk

Received February 7, 2004; de novo received June 7, 2004; accepted July 16, 2004.

Background— Therapeutic hypothermia can improve survival after cardiopulmonary resuscitation (CPR). Coenzyme Q10 (CoQ10) has shown a protective effect in neurodegenerative disorders. We investigated whether combining mild hypothermia with CoQ10 after out-of-hospital cardiac arrest provides additional benefit.

Methods and Results— Forty-nine patients were randomly assigned to either hypothermia plus CoQ10 or hypothermia plus placebo after CPR. Hypothermia with a core temperature of 35°C was instituted for 24 hours. Liquid CoQ10 250 mg followed by 150 mg TID for 5 days or placebo was administered through nasogastric tube. Age, sex, premorbidity, cause of arrest, conditions of CPR, and degree of hypoxia were similar in both groups; no side effects of CoQ10 were identified. Three-month survival in the CoQ10 group was 68% (17 of 25) and 29% (7 of 24) in the placebo group (P=0.0413). Nine CoQ10 patients versus 5 placebo patients survived with a Glasgow Outcome Scale of 4 or 5. Mean serum S100 protein 24 hours after CPR was significantly lower in the CoQ10 group (0.47 versus 3.5 ng/mL).

Conclusions— Combining CoQ10 with mild hypothermia immediately after CPR appears to improve survival and may improve neurological outcome in survivors.

Key Words: heart arrest • metabolism • brain • free radicals

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