Lower Coenzyme Q10 (CoQ₁₀₎) levels have been linked to mortality in chronic heart failure in a study published in the Journal of American College of Cardiology today (Molyneux et al, J Am Coll Cardiol 2008;52 1435-1441). CoQ₁₀ is an essential co-factor for mitochondrial electron transport and myocardial energy supply. Low total cholesterol has been linked with higher mortality in heart failure. Plasma CoQ₁₀ levels are associated with LDL cholesterol levels and this might be a link between the two. The study by Molyneux et al, included 236 patients hositalised for heart failure and found that CoQ₁₀ is an independant predictor of mortality. They go on to recommend controlled intervention studies with CoQ₁₀ as low CoQ₁₀ levels might be detrimental to prognosis in chronic heart failure.