Study on the Effect of COQ10 on Heart Recovery After Coronary Intervention in Coronary Heart Disease

 Coronary atherosclerotic heart disease (CHD) is a condition in which yellow, waxy plaque builds up in the coronary arteries (coronary arteries), and the plaque builds up inside the arteries to form atherosclerosis [1]. As the disease progresses, the plaque hardens and ruptures, narrowing the coronary arteries and affecting the blood supply to the heart muscle [2], and the ruptured plaque forms a thrombus that blocks the coronary arteries, narrowing them and causing myocardial ischemia, hypoxia, and myocardial damage. Coronary heart disease has significant regional differences, generally higher in the north than in the south of China, higher in urban than in rural areas, and is on the rise [3].

 

Coronary heart disease (CHD) remains one of the diseases with the highest morbidity and mortality rates. Intervention of risk factors (hypertension, dyslipidemia, obesity, diabetes mellitus, poor lifestyle, etc.) can help in the prevention and treatment of CHD [4]. Intervention is often used in addition to pharmacologic therapy in clinical practice. Aspirin combined with clopidogrel is one of the main therapeutic agents in patients with coronary artery disease and before and after percutaneous coronary intervention. Coenzyme Q10 (CoQ10) is a fat-soluble compound located mainly in the inner mitochondrial membrane of cells, and is involved in electron transport in the respiratory chain, antioxidant, metabolic regulation, and regulation of cell differentiation.

 

Coenzyme Q10 is synthesized by itself and ingested externally, of which exogenous supplementation is the most important. It has the effects of vasodilating, reducing blood viscosity and peripheral resistance, increasing arterial blood flow, inhibiting platelet aggregation, promoting fibrinolysis, and lowering blood lipids, etc., and is used in the treatment of a variety of cardiovascular diseases because of its effects on anti-inflammation and reduction of vascular proliferation through its influence on NF-κB [5]. In this study, 79 cases of coronary heart disease patients admitted to Beijing Anzhen Hospital from August 2017 to August 2018 were studied, and the effect of coenzyme Q10 on cardiac function after coronary intervention was investigated.

 

1 Information and Methodology

1.1 Research Target

Eighty-six cases of coronary heart disease patients admitted to Bejing Anzhen Hospital from August 2017 to August 2018 were selected, of which 7 cases were lost to visit, with a loss of visit rate of 8.14%, and 79 coronary heart disease patients were followed up as the study subjects, which were divided into the control group and the study group according to the randomized numerical table method. The control group consisted of 40 cases, including 18 females and 22 males, aged 53-78 years, with an average age of 63.87±12.34 years. There were 39 cases in the study group, including 20 females and 19 males, aged 52-78 years, with an average age of 64.17±11.78 years. There was no statistical difference between the two groups in terms of gender, age, and other basic information (P＞0.05).

 

This study was approved by the Ethics Committee of our hospital. Inclusion criteria: ① Referring to the "Diagnostic Criteria for Coronary Atherosclerotic Heart Disease (WS319 2010)"[6] , all patients were diagnosed with coronary heart disease and underwent percutaneous coronary intervention, and there were no contraindications to the use of drugs in this study; ② In addition to the clinical symptoms of angina pectoris, they also manifested palpitations, chest tightness, and fatigue, etc.; ③ All the patients agreed to voluntarily participate in the experiment and signed an informed consent form. (iii) All patients agreed to participate in the experiment and signed the informed consent form. Exclusion criteria: ① severe hepatic and renal insufficiency or cardiac failure, hematopoietic and coagulation disorders; ② asymptomatic myocardial ischemia or myocardial infarction in the acute stage of the patient; ③ serious cardiac arrhythmia or antiplatelet drugs within the past month; ④ with surgery or trauma, drug or alcohol dependence history.

 

1.1 Methodologies  

Both groups were given basic treatment before and after the interventional therapy, avoiding factors that trigger angina attacks (such as excessive physical activity, agitation, etc.). In the control group, the patients were treated with conventional coronary heart disease treatment. The study group was given coenzyme Q10 (10mg/bottle, China National Drug Standard H10930021, Eisai China Pharmaceutical Co., Ltd.) 10 mg, 3/d, and the efficacy of the treatment was evaluated after 1, 3, and 6 months of treatment.

 

1.2 Observation Indicators  

Clinical efficacy: obvious effect: clinical symptoms and signs disappeared, cardiac function recovered to class Ι or improved class Ⅱ; effective: cardiac function improved class Ι; ineffective cardiac function has not been significantly improved or symptoms worsened. The total effective rate = (obvious effect + effective)/total number of cases × 100%[7]. 6-min walking experiment: patients were asked to walk as fast as possible in a straight corridor, and if symptoms such as chest pain, chest tightness, sweating, or pallor appeared in the course of the walking, they had to stop, and the cardiac function was evaluated according to the 6-min walking distance. 1-min walking distance <150m indicated that the patient had severe heart failure, and 1-min walking distance between 150~450m indicated that the patient was in serious heart failure, and 1-min walking distance between 150~450m indicated that the patient had severe heart failure. A 1-min walking distance of 150-450 m indicates severe heart failure, and a 1-min walking distance of >450 m indicates mild heart failure, which means that the patient's heart function is still good or the effect of medication is good [8].

 

Cardiac function indexes: left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) were examined in the patients of the two groups before and after the treatment [9]. Coagulation indices: 5 ml of venous blood was drawn from patients before and 1, 3, and 6 months after the drug was administered, and the patients' prothrombin time (PT), fibrinogen (FIB) content, and maximal platelet aggregation rate (MPAR) were measured [10]. Inflammatory factor levels: Measure the levels of ultrasensitive C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in the serum of the patients before and after the administration of the drug. Adverse drug reactions (ADRs) were observed and recorded during the treatment period[11] . 1.4 Statistical methods SPSS 22.0 was used for statistical analysis. Data were analyzed using SPSS 22.0. The count data were expressed as percentage (%) with χ2 test; the measurement data were expressed as (x ± s) with t test. The difference was considered statistically significant at P < 0.05.

 

2 Results

2.1 Comparison of Baseline Conditions Between the Two Groups of Patients

There was no statistical difference between the two groups in terms of age, gender, blood glucose, blood lipids, smoking, history of hypertension, diabetes mellitus and medication history (P＞0.05), Table 1. 2.2 Comparison of clinical efficacy between the two groups before and after treatment There was an overall efficiency of 94.9% in the study group, which was higher than that of the control group of 82.5%, and the difference had a statistically significant difference (P＜0.05), Table 2.

Table 1 Comparison of the basic data of the two groups of patients

 

particulars	Control group (n=40)	Study group (n=39)	P-value
Age (years)	63.87 ± 12.34	64.17 ± 11.78	0.096
Male (n, %)	18 (45)	19 (48.7)	0.159
Blood glucose (mmol/L)	5.01±0.65	4.98±0.63	0.089
Lipids (mmol/L)	5.21±0.32	5.23±0.31	0.098
ACEI	11 (27.5)	10 (25.6)	0.232
beta-blocker	15 (37.5)	16 (41)	0.474
Smoking history (n, %)	5 (12.5)	6 (15.4)	0.365
History of hypertension (n, %)	8 (20)	8 (20.5)	0.453
History of diabetes (n, %)	4 (10)	3 (7.7)	0.325

Table 2 Comparison of the clinical outcomes of the two groups of patients before and after treatment

 

groups	number of examples	produce an effect (n, %)	validity (n, %)	null (n, %)	Overall effectiveness (%)
control subjects	40	18 (45)	15 (37.5)	7 (17.5)	82.5
research group	39	20 (51.3)	17 (43.6)	2 (5.1)	94.9
P value <0.05

 

2.3 Comparison of Cardiac Function Indexes Before and After Treatment in Two Groups

After 6 months of treatment, the ejection fraction LV EF of both groups increased, while LVEDD, LVESD and LVESV decreased, with statistical differences (P < 0.05). After treatment, the cardiac function indexes of patients in the study group were significantly better than those of the control group, and the difference was statistically significant (P < 0.05), Table 3.

Table 3 Comparison of cardiac function indexes before and after treatment in two groups of patients

 

groups	Observation time	LVEF (%)	LVEDD (mm)	LVESD (mm)	LVESV (ml)
Control group (n=40)	pre-treatment	45.38±3.57	55.86±3.37	52.48±4.08	146.32±34.28
	post-treatment	55.67±2.68a	47.38±2.95a	41.36±3.58a	115.47±14.52a
Study group (n=39)	pre-treatment	46.13±3.15	55.18±3.21	52.85±3.97	146.87±35.02
	post-treatment	60.25±2.42ab	41.39±2.27ab	31.58±3.02ab	101.38±11.76ab

Note: LVEF: left ventricular ejection fraction; LVEDD: left ventricular end-diastolic internal diameter; LVESD: left ventricular end-systolic internal diameter; LVESV: left ventricular end-systolic volume; compared with pretreatment.