Key result
EECP extends time to ST depression and reduces angina episodes vs inactive counterpulsation in CAD.
Why the study?
Case series have shown that EECP can improve exercise tolerance, symptoms, and myocardial perfusion in stable angina pectoris, but controlled trial data were needed.
Does enhanced external counterpulsation improve exercise-induced myocardial ischemia and reduce anginal episodes in outpatients with symptomatic coronary artery disease?
Population
139 outpatients with angina and documented CAD with positive exercise treadmill test
Comparison
Active counterpulsation vs inactive counterpulsation
Design
Multicenter, prospective, randomized, blinded, controlled trial
Follow-up
Four to seven weeks
Authors
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Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“EECP is an intriguing technology which may offer benefit for patients with severe chronic angina, who are often no longer suitable candidates for revascularization procedures. The heterogeneous nature of the limited study population as well as the number of patients lost to follow-up limit the conclusions that can be drawn from the MUST-EECP study. Variation in severity of illness at baseline contributed to a broad range of QOL scores during follow-up. The benefit of this technology remains to be quantified in larger trials.”
Enhanced external counterpulsation extends the time to exercise-induced ischemia and reduces angina episodes in patients with symptomatic coronary artery disease.
RCT (n=139)
blinded
randomized
Yes
Does enhanced external counterpulsation improve exercise-induced myocardial ischemia and reduce anginal episodes in outpatients with symptomatic coronary artery disease?
p-value: p=0.01
Enhanced external counterpulsation extends the time to exercise-induced ischemia and reduces angina episodes in patients with symptomatic coronary artery disease.
Arora et al. (1999) conducted an RCT in angina and documented coronary artery disease (n=139). Enhanced external counterpulsation (active CP) vs. Inactive counterpulsation (inactive CP) was evaluated on Exercise duration, time to ≥1-mm ST-segment depression, average daily anginal attack count, and nitroglycerin usage (p=0.01). Enhanced external counterpulsation increased time to ≥1-mm ST-segment depression (p=0.01) and decreased angina episodes (p<0.05) compared with inactive counterpulsation in patients with CAD.
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