Adjuvant treatment of heart failure with Coenzyme Q10 has a very high probability of being clinically effective and more cost effective than conventional heart failure treatment alone. Adjuvant treatment – that is, adding daily CoQ10 supplementation to the conventional medication for heart failure – is very likely to have a positive effect [Claxton 2022]:

  • on survival
  • on quality of life
  • on the risk of hospitalization,
  • on shorter-term functional outcomes
  • on the cost-effectiveness of treatment

Adding 3 times 100 mg daily CoQ10 supplementation to conventional medication for heart failure reduces the risk of hospitalization and increases the chance of survival.

These are the conclusions to be drawn from a systematic review of randomized controlled trials that compared Coenzyme Q10 plus standard care with standard care alone in cases of chronic heart failure with reduced ejection fraction. The review drew on data from 26 trials enrolling 2250 patients [Claxton 2022].

The Q-SYMBIO trial was the largest trial included in the review. In the Q-SYMBIO trial, researchers used a daily dose of 100 mg three times per day to maximize the serum CoQ10 level. Compared to the placebo group receiving conventional medication alone, the group of heart failure patients taking the daily Coenzyme Q10 in addition to the conventional medication had significantly better survival and quality of life [Mortensen 2014].

Effect of Coenzyme Q10 on Cardiac Function

Alarcón-Vieco conducted a review of ten meta-analyses that measured the effect of Coenzyme Q10 on cardiac function, i.e., on ejection fraction, cardiac output, cardiac index, stroke volume, and quality of life defined as an effect on mortality, exercise capacity, and New York Heart Association classification. They found that Coenzyme Q10 shows a potential beneficial effect on heart function, in particular on survival and hospitalization [Alarcón-Vieco 2023].

Effect of Coenzyme Q10 on Hospitalization

Al Saadi et al conducted a Cochrane Database review of 11 studies with 1573 patients, comparing Coenzyme Q10 to placebo or conventional therapy. They concluded that the studies provide moderate-quality evidence that Coenzyme Q10 reduces all-cause mortality and hospitalization in heart failure patients [Al Saadi 2021].

Insider's Guide to Coenzyme Q10

The Substance That Powers Life: An Insider’s Guide to Coenzyme Q10 by Dr. William V. Judy is available from

Effect of Coenzyme Q10 on Exercise Capacity

Lei and Liu reviewed data from 14 randomized controlled trials enrolling 2149 heart failure patients. They found Coenzyme Q10 significantly decreased the risk of mortality and significantly improved exercise capacity [Lei & Liu 2017].

Conclusions: Adjuvant CoQ10 Treatment for Heart Failure

Claxton et al [2022] concluded that Coenzyme Q10 has the potential to be a clinically effective and cost-effective intervention for chronic heart failure patients with reduced ejection fraction.

The ability of the CoQ10 supplementation to contribute to better outcomes in heart failure depends upon absorption and bioavailabillity [Lopez-Lluch 2019].

It is important to purchase a CoQ10 product with documented scientific evidence of absorption and/or clinical efficacy [Judy 2018].


Al Saadi T, Assaf Y, Farwati M, Turkmani K, Al-Mouakeh A, Shebli B, Khoja M, Essali A, Madmani ME. Coenzyme Q10 for heart failure. Cochrane Database Syst Rev. 2021 Feb 3;(2)(2):CD008684.

Alarcón-Vieco E, Martínez-García I, Sequí-Domínguez I, Rodríguez-Gutiérrez E, Moreno-Herráiza N, Pascual-Morena C.  Effect of coenzyme Q10 on cardiac function and survival in heart failure: an overview of systematic reviews and meta-analyses. Food Funct. 2023;14:6302-6311.

Claxton L, Simmonds M, Beresford L, Cubbon R, Dayer M, Gottlieb SS, Hartshorne-Evans N, Kilroy B, Llewellyn A, Rothery C, Sharif S, Tierney JF, Witte KK, Wright K, Stewart LA. Coenzyme Q10 to manage chronic heart failure with a reduced ejection fraction: a systematic review and economic evaluation. Health Technol Assess. 2022 Jan;26(4):1-128.

Judy, William V. The Substance That Powers Life: Coenzyme Q10, An Insider’s Guide. 2018. ISBN 978-87-7776-186-7. Available from

Lei L, Liu Y. Efficacy of coenzyme Q10 in patients with cardiac failure: a meta-analysis of clinical trials. BMC Cardiovasc Disord. 2017 Jul 24;17(1):196.

López-Lluch G, Del Pozo-Cruz J, Sánchez-Cuesta A, Cortés-Rodríguez AB, Navas P. Bioavailability of coenzyme Q10 supplements depends on carrier lipids and solubilization. Nutrition. 2019 Jan;57:133-140.

Mortensen SA, Rosenfeldt F, Kumar A, Dolliner P, Filipiak KJ, Pella D, Alehagen U, Steurer G, Littarru GP; Q-SYMBIO Study Investigators. The effect of coenzyme Q10 on morbidity and mortality in chronic heart failure: results from Q-SYMBIO: a randomized double-blind trial. JACC Heart Fail. 2014 Dec;2(6):641-9.

The information presented in this review article is not intended as medical advice and should not be used as such.