Enhanced External Counterpulsation in the Treatment of Chronic Refractory Angina: A Long‐term Follow‐up Outcome from the International Enhanced External Counterpulsation Patient Registry
- 10 April 2008
- journal article
- research article
- Published by Wiley in Clinical Cardiology
- Vol. 31 (4), 159-164
- https://doi.org/10.1002/clc.20117
Abstract
Background The management of patients who suffer from medically refractory angina and are unsuitable for conventional revascularization therapy is often unsatisfactory. Enhanced external counterpulsation (EECP) is a noninvasive treatment that is safe and effective immediately after a course of treatment. However, the duration of benefit is less certain. Hypothesis To evaluate the 3‐year outcome of EECP treatment. Methods One thousand four hundred and twenty seven patients from 36 centers registered in the International EECP Patient Registry (IEPR)—Phase 1 was prospectively followed for a median of 37 months. Two hundred and twenty patients (15.4%) died, while 1,061 patients (74.4%) completed their follow‐up. Results The mean age was 66 ± 11 years and 72% were men. Seventy‐six percent had multivessel coronary disease for 11 ± 8 years. Eighty‐eight percent had a prior percutaneous or surgical revascularization and 82% were unsuitable for further coronary intervention. Immediately post‐EECP, the proportion of patients with severe angina (Canadian Cardiovascular Angina Classification [CCS] III/IV) were reduced from 89% to 25%, p<0.001. The CCS class was improved by at least 1 class in 78% of the patients and by at least 2 classes in 38%. This was sustained in 74% of the patients during follow‐up. Thirty‐six percent of the patients had CCS II or less angina, which was better than pre‐EECP state without a major adverse cardiovascular event during follow‐up. More severe baseline angina and a history of heart failure or diabetes were independent predictors of unfavorable outcome. Conclusion An EECP improves angina and quality of life immediately after a course of treatment. For most of the patients, these beneficial effects are sustained for 3 years. CopyrightKeywords
This publication has 20 references indexed in Scilit:
- The immediate and long‐term outcome of enhanced external counterpulsation in treatment of chronic stable refractory anginaJournal of Internal Medicine, 2006
- The effects of enhanced external counterpulsation on myocardial perfusion in patients with stable angina: A multicenter radionuclide studyAmerican Heart Journal, 2005
- Predictors of Benefit in Angina Patients One Year after Completing Enhanced External Counterpulsation: Initial Responders to Treatment versus NonrespondersCardiology, 2005
- Improvement of oxygen metabolism in ischemic myocardium as a result of enhanced external counterpulsation with heparin pretreatment for patients with stable anginaHeart and Vessels, 2004
- Effect of enhanced external counterpulsation on dobutamine-induced left ventricular wall motion abnormalities in severe chronic angina pectorisThe American Journal of Cardiology, 2004
- Enhanced external counterpulsation for ischemic heart disease: What’s behind the curtain?Journal of the American College of Cardiology, 2003
- The problem of chronic refractory angina. Report from the ESC Joint Study Group on the Treatment of Refractory AnginaEuropean Heart Journal, 2002
- Enhanced external counterpulsation improved myocardial perfusion and coronary flow reserve in patients with chronic stable angina. Evaluation by13N-ammonia positron emission tomographyEuropean Heart Journal, 2001
- The international EECP patient registry (IEPR): Design, methods, baseline characteristics, and acute resultsClinical Cardiology, 2001
- Three-year sustained benefit from enhanced external counterpulsation in chronic angina pectorisThe American Journal of Cardiology, 1995