Clinical observation on the treatment of coronary heart disease with ventricular pre-systole by coenzyme Q10

 Abstract Objective: To investigate the clinical efficacy of coenzyme Q10 in the treatment of coronary heart disease and ventricular pre-systole. Methods: 120 patients with coronary artery disease and ventricular pre-systole were randomly divided into 60 patients in the treatment group and 60 patients in the control group, 60 patients in the control group were given oral probenecid 150 mg/time, 3 times /d. 60 patients in the treatment group were given COQ10 10 mg, intramuscular injection, 1 time /d on the basis of the control group, and 4 weeks of treatment were given to both groups.

 

RESULTS: After treatment, the total effective rate was 100% in the treatment group and 68.3% in the control group, and the difference between the two groups was statistically significant (P<0.01). Meanwhile, 36 patients in the treatment group showed significant improvement in ischemic ST-T after treatment. Conclusion: On the basis of conventional treatment, COQ10 has reliable efficacy in treating ventricular pre-systole complicated by coronary heart disease, is safe, has no serious toxic side effects, and has clinical popularization value.

 

Coronary heart disease (CHD) is one of the common cardiovascular diseases, which is often associated with arrhythmia and other complications, seriously threatening people's health and life safety. With the rapid development of free radical biology and free radical medicine in the last half year, people have paid great attention to the cardiovascular and cerebrovascular diseases and their complications caused by structural damage and dysfunction of biofilm due to lipid peroxidation damage under the impact of oxygen free radicals (OFR) [1-2], and have started to explore the therapeutic effects of anti-OFR drugs on these diseases.

 

COQ10 has antioxidant, anti-self  COQ10 has the function of antioxidant, elimination of free radicals, and has a good clinical effect on the treatment of coronary heart disease and ventricular pre-systole. Since 2013, the author's hospital has been observing the clinical treatment of patients with coronary artery disease and ventricular pre-systole with coenzyme Q10 (COQ10), and has achieved good therapeutic effects.

 

1 Information and methodology

1.1 General information

One hundred and twenty patients with coronary heart disease and ventricular pre-systole admitted to the author's hospital from March 2012 to August 2015 were selected, and all of them were clinically diagnosed in accordance with the WHO diagnostic criteria for coronary heart disease [3] and had ventricular pre-systole by electrocardiographic monitoring. There were 72 males and 48 females, aged 32-71 years, mean (48.2±2.6) years, with a disease duration of 9-21 years, mean (8.1±1.8) years. The patients were randomly divided into 60 cases in the treatment group and 60 cases in the control group. Among the 60 cases in the treatment group, there were 38 males and 22 females, aged 32-70 years, with an average of (48.6±2.8) years, and the duration of the disease ranged from 9 to 21 years, with an average of (8.3±1.7) years; among the 60 cases in the control group, there were 34 males and 26 females, aged 33-71 years, with an average of (48.7±2.7) years, and the duration of the disease ranged from 9 to 19 years, with an average of (7.9±1.9) years. There was no statistically significant difference between the two groups in terms of gender, age, duration of disease and degree of disease (P>0.05), and they were comparable.

 

1.2 Treatment

1.2.1 Control group    

In addition to the conventional treatment of coronary heart disease, propafenone 150 mg/times, 3 times/d was given orally.

 

1.2.2 Treatment group    

On the basis of the treatment in the control group, COQ10 10 mg was given intramuscularly once /d.

Both groups were treated for 4 weeks. At the same time, 24-hour cardiac monitoring was performed for monitoring.

 

1.3 Observation indicators

The 24-hour ambulatory electrocardiographic monitor was used, and the electrocardiogram was checked once before the first dose of the drug, and the number of pre-systolic contractions within 5 minutes was counted, and the electrocardiogram was observed every 1 hour after the first dose of the drug, and the number of pre-systolic contractions within 5 minutes was recorded. After the first dose, the ECG was observed every 1 h, and the number of preterm contractions within 5 min was recorded.

 

1.4 Criteria for determining efficacy

The efficacy was evaluated according to the "Reference Standards for Arrhythmia Severity and Efficacy" revised by the 1979 National Symposium on Combined Chinese and Western Medicine for the Prevention and Treatment of Coronary Heart Disease and Arrhythmia [4]. Significant effect: complete disappearance or reduction of ventricular pre-systole to 1-5 times/min or reduction of electrocardiographic ventricular pre-systole by more than 75% after treatment, disappearance of clinical symptoms and signs, and competence in general work; Effective: reduction of ventricular pre-systole by more than 50% after treatment, with slight palpitation and fatigue, and competence in light physical labor; Ineffective: failure to meet the criteria for improvement after treatment; Worsening: reduction of ventricular pre-systole by less than 50% or no change in 24 h after treatment. Deterioration: ventricular pre-systolic contractions decreased by less than 50% in 24 h, or no change, or increased in frequency and severity. Total effect = significant effect + effective.

 

1.5 Statistical processing

The obtained data were statistically analyzed using SPSS 13.0 statistical software. Measurement data were expressed as (x- ±s) and t-test was used, while count data were tested by X2 test, and P<0.05 was regarded as statistically significant difference.

 

2 Results

2.1 Comparison of the efficacy of the two groups

After one course of treatment, the total effective rate was 95.0% in the treatment group and 48.3% in the control group, and the difference was statistically significant after statistical treatment (P<0.01). The total effective rate was 95.0% in the treatment group and 48.3% in the control group after one course of treatment, and the difference was statistically significant (P<0.01). 3 patients in the treatment group who were ineffective and continued to be treated for 1 course of treatment had significant effect, with the total effective rate of 100%. 26 patients in the control group who were ineffective and continued to be treated for 1 course of treatment had significant effect, with the total effective rate of 68.3%, and the difference was statistically significant (P<0.01), as shown in Table 1. 36 patients in the treatment group had significant improvement of ischemic ST-T after the treatment.

 

Table 1 Comparison of therapeutic efficacy between the two groups Cases (%)

groups	produce an effect	efficiently	null	aggravate	total effective
Treatment group (n=60)	50 (83.3)*	10 (16.7)	0	0	60 (100)*
Control group (n=60)	34 (56.7)	7 (11.7)	19 (31.7)	0	41 (68.3)

 

* :: P<0.01 compared with control group

 

2.2 Comparison of time to disappearance of preterm contractions and number of days of treatment between the two groups

In the treatment group, the onset of effect was 6-8 h after drug administration, the peak was reached in 10 h, and the disappearance of preperiodic contraction was 18 h at the earliest and 19 d at the latest, with the shortest period of treatment being 3 d and the longest period being 16 d, and the average was 7.6±1.6 d. In the control group, the onset of effect was 24-48 h after drug administration, the peak was reached in 72 h, and the disappearance of preperiodic contraction was 22 h at the earliest and 26 d at the latest, with the shortest period of treatment being 6 d and the longest period being 21 d, and the average was 11.8±2.1 d. There was a statistically significant difference in the number of treatment days of both groups (P<0.05). The shortest treatment period was 6 d, and the longest was 21 d, with an average of (11.8±2.1) d. The difference in the number of treatment days between the two groups was statistically significant (P<0.05).

 

2.3 Safety observations

No serious toxic side effects were observed in all cases during the treatment period, and no cases of cardiac, hepatic or renal impairment occurred.

 

3 Discussion

Coronary artery disease combined with ventricular pre-systole is one of the most common acute and critical diseases in cardiovascular medicine, and also one of the most common arrhythmias, which has the characteristics of sudden onset, dangerous evolution of the disease, high mortality rate, and poor prognosis, and the inappropriate or untimely treatment can induce ventricular tachycardia, ventricular fibrillation and other fatal arrhythmias, which can increase the mortality rate of the patients, and it has become the main reason for the patient's death. This has seriously reduced the quality of life of patients [5] and has brought huge economic losses and mental burden to patients and families. Therefore, how to reduce the incidence of ventricular pre-systole complicated by coronary artery disease, reduce the mortality rate, improve the quality of life of patients, and prolong their lives has become a topic that cardiology clinicians are trying to solve and research.

 

At present, there are many drugs available for its treatment, but the treatment duration is long, the effect is slow, the side effects are many, the price is high, and it brings pain to the patients physically and mentally. In order to explore the role of COQ10 in coronary heart disease combined with ventricular pre-systole, the author conducted a clinical study of COQ10 treatment of coronary heart disease combined with ventricular pre-systole, after clinical treatment showed that the drug treatment of coronary heart disease combined with ventricular pre-systole is not only good, but also high efficacy, safety and no toxic side effects, and has achieved significant social and economic benefits.

 

Clinical studies have demonstrated that patients with coronary artery disease (CAD) have significantly higher levels of OFR than normal subjects, while their ability to remove OFR is significantly lower than normal [6]. Lipid peroxidation caused by OFR can lead to fatal damage to myocardial cell membranes, resulting in arrhythmias [7]. COQ10 has the properties of anti-peroxidation and cell membrane stabilization, and it can scavenge OFR [8], promote oxidative phosphatase reaction, maintain the structural integrity of mitochondria, and prevent aberrations due to ischemia, so it has a protective effect on the myocardium [9]. The application of COQ10 treatment can significantly increase the myocardial ATP content, improve myocardial ischemia and hypoxia, prevent reperfusion injury, and eliminate the occurrence of ectopic excitation caused by myocardial ischemia, thus effectively controlling the occurrence of ventricular pre-systole.

 

In animal experiments, COQ10 was found to prolong the duration of papillary muscle action potential and lower the threshold of ischemic ventricular fibrillation [10]. According to the study, COQ10 is not only an activator of cellular respiration and cellular metabolism, but also an important antioxidant and non-specific immune enhancer, which can protect the structural integrity of biological membranes, and has the effects of anti-arrhythmia, anti-myocardial ischemia, improvement of energy metabolism in myocardium, and scavenging of oxygen radicals, etc. The mechanism of COQ10 can also protect the structural integrity of biological membranes.

 

Propiophenone is a class Ic drug with certain β-blocking effect, which is clinically used in the treatment of arrhythmia. The combination of the two drugs has a synergistic effect on improving myocardial ischemia and hypoxia and correcting arrhythmia. This is also evidenced by the improvement of ischemic ST-T in the ECG of 36 cases in the treatment group after treatment. In this group, the total effective rate was 100% in the treatment group and 68.3% in the control group, the difference was statistically significant (P<0.01), which proved that the combination of COQ10 and other antiarrhythmic drugs could significantly reduce the ventricular pre-systole, and the treatment of coronary artery disease and ventricular pre-systole had a comparable therapeutic efficacy.

 

This study shows that COQ10 has reliable efficacy in the treatment of ventricular pre-systole complicated by coronary heart disease, is safe and has no serious toxic side effects, and has opened up an effective treatment method for the treatment of ventricular pre-systole complicated by coronary heart disease. This study shows that this treatment is safe and effective, and can reduce the occurrence of cardiovascular events. It is also low-cost, reduces the cost of medicines, is convenient to take medicines, and is easy to be accepted by the patients, which can reduce the economic burden of the patients, and it has high social and economic benefits in reducing poverty caused by illness and poverty caused by illness. At the same time, it can improve the quality of life of patients and prolong their life expectancy, which has a better prospect of clinical application and is worthwhile to be popularized and applied in the clinic.

 

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