Enhanced external counterpulsation is an effective treatment for Syndrome X

Area of Science:

• Cardiology
• Vascular Medicine
• Internal Medicine

Background:

• Cardiac Syndrome X presents as refractory angina.
• Limited effective treatment options exist for this condition.
• Endothelial dysfunction plays a role in cardiac Syndrome X.

Purpose of the Study:

• To evaluate the efficacy and durability of Enhanced External Counterpulsation (EECP) for refractory angina in Cardiac Syndrome X.
• To assess the impact of EECP on angina class, ischemia, and major adverse cardiac events (MACE).

Main Methods:

• Thirty patients with refractory angina due to Cardiac Syndrome X were treated with EECP.
• Clinical outcomes including Canadian Cardiovascular Society (CCS) angina class were assessed.
• Follow-up included assessment of angina recurrence and MACE.

Main Results:

• Significant improvement in CCS angina class from 3.57 to 1.43 (p<0.001).
• All patients showed improvement in regional ischemia.
• At a mean follow-up of 11.9 months, 87% of patients had sustained angina improvement and remained free of MACE.
• EECP demonstrated improvement in endothelial function.

Conclusions:

• Enhanced External Counterpulsation is an effective and durable treatment for refractory angina in Cardiac Syndrome X.
• EECP may improve endothelial function, contributing to sustained symptom relief.
• This therapy offers a valuable option for patients with difficult-to-treat angina.