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Cardiac Shock Wave Therapy for Coronary Heart Disease: an Updated Meta-analysis
Hai-Tao Yang1, Xiang Xie1, Xian-Geng Hou2
1Xinjiang Medical University First Affiliated Hospital Department of Cardiology Urumchi People's Republic of China Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumchi, People's Republic of China.
Insights
Cardiac shock wave therapy (CSWT) shows promise for treating coronary heart disease (CAD), improving exercise capacity and angina symptoms. Further large-scale studies are needed to confirm these beneficial effects in CAD patients.
Area of Science:
- Cardiology
- Medical Devices
- Regenerative Medicine
Background:
- Coronary heart disease (CAD) remains a leading cause of mortality worldwide.
- Current treatments for CAD have limitations, necessitating novel therapeutic approaches.
- Cardiac shock wave therapy (CSWT) is an emerging non-invasive treatment modality.
Purpose of the Study:
- To evaluate the efficacy and safety of cardiac shock wave therapy (CSWT) in patients with coronary heart disease (CAD).
- To synthesize existing evidence through meta-analysis to determine the therapeutic impact of CSWT.
Main Methods:
- A systematic literature search was conducted across electronic databases and conference proceedings up to September 2018.
- Meta-analyses were performed on data from 26 studies involving 855 patients (781 treated with CSWT).
- Key indicators analyzed included 6-min walking distance (6MWT), NYHA functional class, SAQ score, CCS angina class, and LVEF.
Main Results:
- CSWT significantly improved 6MWT (MD 75.64) and NYHA functional class (MD -0.70) compared to conventional revascularization.
- Significant improvements were observed in SAQ scores (MD 10.75), CCS angina class (MD -0.99), and reduced nitrate dosage (MD -1.84).
- Left ventricular ejection fraction (LVEF) improved (MD 3.77), along with significant changes in SSS, SRS, and exercise test results.
Conclusions:
- Cardiac shock wave therapy (CSWT) demonstrates potential beneficial effects for patients suffering from coronary heart disease (CAD).
- The findings suggest CSWT can enhance functional capacity and alleviate angina symptoms.
- Larger, high-quality clinical trials are warranted to definitively establish the therapeutic efficacy and long-term safety of CSWT in CAD management.
Introduction:
The aim of this article is to study the efficacy and safety of cardiac shock wave therapy (CSWT) in the treatment of coronary heart disease (CAD).
Methods:
A comprehensive search of electronic databases and a manual search of conference papers and abstracts were performed until September 30, 2018. The studies using RevMan 5.3 and STATA 14.0 softwares were reviewed, and meta-analyses were performed on 13 indicators, such as a six-min walking distance test (6MWT), New York Heart Association (NYHA) functional class, Seattle Angina Questionnaire (SAQ) score, angina class (Canadian Cardiology Society [CCS]), etc.
Results:
A total of 26 articles were included. The total patient population was 855, of which 781 patients were treated with CSWT. Meta-analyses indicated that 6MWT (mean difference [MD] 75.64, 95% confidence interval [CI] 49.03, 102.25, P<0.00001) and NYHA (MD -0.70, 95% CI -0.92) in the CSWT group were comparable to those in the conventional revascularization group (MD -0.70, 95% CI -0.92, -0.49, P<0.00001). SAQ (MD 10.75, 95% CI 6.66, 14.83, P<0.00001), CCS (MD -0.99, 95% CI -1.13, -0.84, P<0.00001), nitrate dosage (MD -1.84, 95% CI -2.77, -1.12, P<0.00001), LVEF (MD 3.77, 95% CI 2.17, 5.37, P<0.00001), and SSS (MD -4.29, 95% CI -5.61, -2.96, P<0.00001), SRS (MD -2.90, 95% CI -4.85, -0.95, P=0.004), and the exercise test (standard mean difference 0.57, 95% CI 0.12, 1.02, P=0.01) all showed significant differences.
Conclusion:
CSWT may offer beneficial effects to patients with CAD, but more large-scale clinical studies are needed to further verify its therapeutic effect.
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