on November 1, 2004
Published online before print November 1, 2004, doi: 10.1161/01.CIR.0000146894.45533.C2
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Submitted on February 7, 2004
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. * To whom correspondence should be addressed. E-mail: msd13{at}le.ac.uk.
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.
Revised on June 7, 2004
Accepted on July 16, 2004
Coenzyme Q10 Combined With Mild Hypothermia After Cardiac Arrest. A Preliminary Study
Maxwell Simon Damian MD, PhD*,
Key words: heart arrest • metabolism • brain • free radicals
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