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Two-year outcomes in patients with mild refractory angina treated with enhanced external counterpulsation

William E Lawson1, John C K Hui, Elizabeth D Kennard

  • 1Cardiovascular Division, SUNY Stony Brook, Stony Brook, New York 11794, USA. William.lawson@stonybrook.edu

Clinical Cardiology
|March 2, 2006
PubMed

Insights

Enhanced external counterpulsation (EECP) effectively reduces angina in patients with Canadian Cardiovascular Society (CCS) class II and III-IV, showing durable improvements and low major adverse cardiovascular events over two years.

Area of Science:

  • Cardiology
  • Noninvasive Cardiovascular Therapies

Background:

  • International Enhanced External Counterpulsation Patient Registry (IEPR) data shows 85% of treated patients have Canadian Cardiovascular Society (CCS) class III-IV angina.
  • These patients often have no further invasive revascularization options.

Purpose of the Study:

  • To evaluate if enhanced external counterpulsation (EECP) benefits patients with less severe CCS class II angina.
  • To assess if EECP's durable angina reduction extends to CCS class II patients without revascularization options.

Main Methods:

  • A comparative analysis of 112 CCS class II patients versus 1346 CCS class III-IV patients from the IEPR.
  • Evaluation of immediate response, 2-year durability, and clinical events following EECP treatment.

Main Results:

  • EECP significantly reduced angina, nitroglycerin use, and improved quality of life in both CCS class II and III-IV groups.
  • At 2-year follow-up, 74% of class II and 70% of class III-IV patients remained free of major adverse cardiovascular events (MACE).
  • Both groups demonstrated durable improvement in CCS class over baseline.

Conclusions:

  • Enhanced external counterpulsation (EECP) is effective for CCS class II refractory angina patients.
  • EECP's noninvasive nature, effectiveness, and cost make it suitable for broader application in refractory angina treatment.
Abstract

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