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One year follow-up of patients with refractory angina pectoris treated with enhanced external counterpulsation
Thomas Pettersson1, Susanne Bondesson, Diodor Cojocaru
1Department of Medicine, Kristianstad, Sweden. thomas.pettersson@skane.se
Insights
Enhanced external counterpulsation (EECP) safely improves angina in refractory patients, with benefits sustained for 12 months. This non-invasive treatment is effective for those with severe chronic angina pectoris.
Area of Science:
- Cardiology
- Non-invasive cardiovascular therapies
Background:
- Enhanced external counterpulsation (EECP) is a non-invasive treatment for angina and myocardial ischemia.
- It is effective in patients unresponsive to medical therapy or revascularization.
- Chronic refractory angina pectoris presents a significant clinical challenge.
Purpose of the Study:
- To evaluate the long-term outcomes of EECP treatment for chronic refractory angina pectoris.
- To assess the efficacy of EECP in relieving angina symptoms at a Scandinavian center.
Main Methods:
- 55 patients with chronic refractory angina pectoris were treated with EECP.
- Canadian Cardiovascular Society (CCS) class, antianginal medication, and adverse events were recorded pre-treatment and at 6 and 12 months post-treatment.
Main Results:
- EECP significantly improved CCS class in 79% of patients (p < 0.001), particularly those with CCS class III and IV.
- Improvements persisted for 12 months, with 73% improving one CCS class and 22% improving two CCS classes.
- A significant decrease in nitroglycerin usage was observed (p < 0.05).
Conclusions:
- EECP is a safe and effective treatment for highly symptomatic patients with refractory angina.
- The beneficial effects of EECP on angina symptoms are sustained over a 12-month follow-up period.
Background:
Enhanced external counterpulsation (EECP) is a non-invasive technique that has been shown to be effective in reducing both angina and myocardial ischemia in patients not responding to medical therapy and without revascularization alternatives. The aim of the present study was to assess the long-term outcome of EECP treatment at a Scandinavian centre, in relieving angina in patients with chronic refractory angina pectoris.
Methods:
55 patients were treated with EECP. Canadian cardiovascular society (CCS) class, antianginal medication and adverse clinical events were collected prior to EECP, at the end of the treatment, and at six and 12 months after EECP treatment. Clinical signs and symptoms were recorded.
Results:
EECP treatment significantly improved the CCS class in 79 +/- 6% of the patients with chronic angina pectoris (p < 0.001). The reduction in CCS angina class was seen in patients with CCS class III and IV and persisted 12 months after EECP treatment. There was no significant relief in angina in patients with CCS class II prior to EECP treatment. 73 +/- 7% of the patients with a reduction in CCS class after EECP treatment improved one CCS class, and 22 +/- 7% of the patients improved two CCS classes. The improvement of two CCS classes could progress over a six months period and tended to be more prominent in patients with CCS class IV. In accordance with the reduction in CCS classes there was a significant decrease in the weekly nitroglycerin usage (p < 0.05).
Conclusion:
The results from the present study show that EECP is a safe treatment for highly symptomatic patients with refractory angina. The beneficial effects were sustained during a 12-months follow-up period.
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