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

AimSurvival 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 Q₁₀ (CoQ₁₀) in post-arrest patients. We hypothesized that plasma CoQ₁₀ levels would be low after CA and associated with poorer outcomes.MethodsProspective observational study of post-arrest patients presenting to a tertiary care center. CoQ₁₀ levels were drawn 24 h 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.Results23 CA subjects and 16 healthy controls were enrolled. CoQ₁₀ levels in CA patients (0.28 μmol L^?1, inter-quartile range (IQR): 0.22–0.39) were significantly lower than in controls (0.75 μmol L^?1, IQR: 0.61–1.08, p < 0.0001). The mean CoQ₁₀ level in CA patients who died was significantly lower than in those who survived (0.27 vs 0.47 μmol L^?1, p = 0.007). There was a significant difference in median CoQ₁₀ level between patients with a good vs poor neurological outcome (0.49 μmol L^?1, IQR: 0.30–0.67 vs 0.27 μmol L^?1, IQR: 0.21–0.30, p = 0.02). CoQ₁₀ was a statistically significant predictor of poor neurologic outcome (adjusted p = 0.02) and in-hospital mortality (adjusted p = 0.026).ConclusionCoQ₁₀ levels are low in human subjects with ROSC after cardiac arrest as compared to healthy controls. CoQ₁₀ levels were lower in those who died, as well as in those with a poor neurologic outcome.