Key result
External counterpulsation is linked to a ~38% higher rate of angina class improvement vs controls.
Why the study?
The effectiveness of external counterpulsation as part of complex treatment for patients with stable angina pectoris was assessed.
Does external counterpulsation improve angina symptoms and quality of life in patients with chronic stable angina?
Cohort (n=92)
No
Does external counterpulsation improve angina symptoms and quality of life in patients with chronic stable angina?
External counterpulsation as part of comprehensive treatment significantly improves angina functional class, reduces nitroglycerin use, and enhances quality of life in patients with chronic stable angina.
Answers are grounded in this paper and cite their sources.
ECP added to medical therapy was associated with greater angina relief; hypothesis-generating and requires randomized confirmation before practice change.
Aim. To assess the effectiveness of the complex treatment of patients with stable angina pectoris using the method of external counterpulsation (ECP). Methods. 92 patients with chronic stable angina were included in the comparative analysis, which divided into 2 groups: 57 patients received one course of treatment using the ECP method (main group), 35 patients received only drug treatment (control group). Before and after the therapy, a general clinical examination (including determining the functional class of angina pectoris and the need to use nitroglycerin preparations), coronary angiography, echocardiography, exercise stress test (stress ECG), and quality assessment using the Seattle Angina Questionnaire (SAQ) was performed. Results. The decrease in the average functional class of angina was more significant in the main group compare to the control group from 2.280.73 to 0.930.80 (p 0.05) versus from 2.340.73 to 1.830.71 (p 0.05). A decrease of at least 1 functional class more often occurred in the main group 78.9% of patients versus 57.1% (p=0.0258). The use of nitroglycerin sharply decreased after treatment in the group, that use the ECP method (by 51.6%; p=0.002), whereas in the control group, despite a slight decrease (by 22.7%), the changes did not reach statistical significance (p=0.0736). Both groups showed similar dynamics of changes in echocardiography. The differences were obtained only for the dynamics of the ejection fraction of the left ventricle (LVEF), which was greater in the main group an increase of 4.695.56% versus 1.755.15% (p=0.0448). The dynamics of all indicators of exercise stress test significantly differ between groups, and if for the main group it is positive, in the control group it is negative. Some indicators of quality of life change insignificant and similar for both groups (for example, on the scale for limiting physical exertion), and on some scales (stability scales for attacks and the frequency of angina attacks), the improvement in the main group is much more significant in comparing with the control group: 3037 points versus 1213 points, respectively (p 0.0001). The overall quality of life assessment score improved more in the group, that use the ECP method: +96.1040.73 versus +45.3135.06 the control group (p 0.0001). Conclusion. The method of external counterpulsation (ECP) can be used in clinical practice as part of a comprehensive treatment of patients with stable angina pectoris; it can significantly reduce the class of angina pectoris and the need to use nitroglycerin preparations, improve a number of indicators of echocardiography, electrocardiography with exercise and quality of life indicators.
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Rovshan Alakbarov (2020) conducted a cohort in Chronic stable angina (n=92). External counterpulsation vs. Medical treatment only was evaluated on Decrease of at least 1 functional class of angina (p=0.0258). External counterpulsation significantly reduced the functional class of angina by at least 1 class in 78.9% of patients compared to 57.1% in the control group.
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