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Related Experiment Video

Updated: Jun 16, 2026

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
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Enhanced external counterpulsation for chronic angina pectoris.

Fawzi Amin1, Amani Al Hajeri, Birol Civelek

  • 1Ministry of Health Bahrain, Box 22118, Manama, Bahrain.

The Cochrane Database of Systematic Reviews
|February 19, 2010
PubMed
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Enhanced external counterpulsation (EECP) is a non-invasive treatment for refractory angina. One trial showed poor methodological quality and excluded severe angina cases, providing inconclusive evidence for EECP effectiveness.

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Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Trials

Background:

  • Cardiovascular disease remains a leading cause of mortality globally.
  • Refractory stable angina pectoris often shows limited response to conventional treatments.
  • Enhanced external counterpulsation (EECP) is a non-invasive therapy utilizing sequential cuff inflation to improve cardiac blood flow and alleviate angina symptoms.

Purpose of the Study:

  • To evaluate the efficacy of enhanced external counterpulsation (EECP) therapy in enhancing health outcomes for patients diagnosed with chronic stable or refractory stable angina pectoris.

Main Methods:

  • A systematic search was conducted across major databases including CENTRAL, MEDLINE, EMBASE, LILACS, and Web of Science.
  • Included studies were randomized controlled trials and cluster-randomized trials comparing EECP to sham treatments in adults (≥18 years) with Canadian Cardiovascular Society Class III to IV angina.
  • Two independent reviewers screened studies, extracted data, and assessed the risk of bias.

Main Results:

  • A single trial with 139 participants was included in this review.
  • The trial exhibited significant methodological limitations, including trial design, conduct, outcome reporting, and statistical analysis, compromising data reliability.
  • Incomplete reporting of primary outcomes and limited follow-up for secondary outcomes further impacted the findings.

Conclusions:

  • The single included trial inadequately represented the target population, excluding patients with the most severe angina.
  • The study's findings are not generalizable to the broader population with chronic angina pectoris.
  • Inconclusive evidence exists regarding the effectiveness of enhanced external counterpulsation therapy for chronic angina based on this review.