Preventing myocardial injury following non‐cardiac surgery: A potential role for preoperative antioxidant therapy with ubiquinone

Qun Chen, Steven Qi, Laura Hocum‐stone, Edward Lesnefsky, Rosemary F. Kelly, Edward O. McFalls

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations


Over 240 million non‐cardiac operations occur each year and are associated with a 15–20% incidence of adverse perioperative cardiovascular events. Unfortunately, preoperative therapies that have been useful for chronic ischemic heart diseases, such as coronary artery revascularization, antiplatelet agents, and beta‐blockers have failed to improve outcomes. In a pre‐clinical swine model of ischemic heart disease, we showed that daily administration of ubiquinone (coenzyme Q10, CoQ10) enhances the antioxidant status of mitochondria within chronically ischemic heart tissue, potentially via a PGC1α‐dependent mechanism. In a randomized controlled trial, among high‐risk patients undergoing elective vascular surgery, we showed that NT Pro‐BNP levels are an important means of risk‐stratification during the perioperative period and can be lowered with administration of CoQ10 (400 mg/day) for 3 days prior to surgery. The review provides background information for the role of oxidant stress and inflammation during high‐risk operations and the potential novel application of ubiquinone as a preoperative antioxidant therapy that might reduce perioperative adverse cardiovascular outcomes.

Original languageEnglish (US)
Article number276
Pages (from-to)1-19
Number of pages19
Issue number2
StatePublished - Feb 2021

Bibliographical note

Funding Information:
Acknowledgments: This work was supported in part by the Office of Research and Development, Medical Research Service (EOM), Merit Review Award (2IO1BX001355‐01A2) (QC, EJL), the Pauley Heart Center, Virginia Commonwealth University (QC, EJL).

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • BNP
  • CoQ10
  • Myocardial injury
  • Outcomes
  • Troponin
  • Ubiquinone
  • Vascular surgery

PubMed: MeSH publication types

  • Review
  • Journal Article


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