Key result
Coronary sinus Reducer implantation linked to improvement of ≥2 CCS classes in ~40% of patients.
Why the study?
Does Coronary sinus Reducer (CSR) implantation improve angina symptoms and is it safe in patients with chronic refractory angina?
Observational (n=658)
Yes
Does Coronary sinus Reducer (CSR) implantation improve angina symptoms and is it safe in patients with chronic refractory angina?
In a large multinational registry of patients with chronic refractory angina, Coronary sinus Reducer implantation was safe and associated with significant symptomatic improvement in the majority of patients.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Real-world data from the RESOURCE (Registry of Coronary Sinus Reducer for Refractory Angina) registry and REDUCER-1 (An Observational Study of the Neovasc Reducer System) study demonstrated high procedural success (>95%), low complication rates, and durable symptomatic benefit, with most patients achieving meaningful improvements in angina severity, functional status, and QoL.”
May support CSR consideration in refractory angina; extends observational data but leaves open randomized confirmation.
Introduction: Refractory angina (RA) is considered the end-stage of coronary artery disease, and often has no interventional treatment options. Coronary sinus Reducer (CSR) is a recent addition to the therapeutic arsenal, but its efficacy has only been evaluated on small populations. The RESOURCE registry provides further insights into this therapy. ... read more Methods: The RESOURCE is an observational, retrospective registry that includes 658 patients with RA from 20 centers in Europe, United Kingdom and Israel. Prespecified endpoints were the amelioration of anginal symptoms evaluated with the Canadian Cardiovascular Society (CCS) score, the rates of procedural success and complications, and MACEs as composite of all-cause mortality, acute coronary syndromes, and stroke. Results: At a median follow-up of 502 days (IQR 225–1091) after CSR implantation, 39.7% of patients improved by ≥2 CCS classes (primary endpoint), and 76% by ≥1 class. Procedural success was achieved in 96.7% of attempts, with 3% of procedures aborted mostly for unsuitable coronary sinus anatomy. Any complication occurred in 5.7% of procedures, but never required bailout surgery nor resulted in intra- or periprocedural death or myocardial infarction. One patient developed periprocedural stroke after inadvertent carotid artery puncture. At the last available follow-up, overall mortality and MACE were 10.4% and 14.6% respectively. At one, three and five years, mortality rate at Kaplan-Meier analysis was 4%, 13.7%, and 23.4% respectively. Conclusions: CSR implantation is safe and reduces angina in patients with refractory angina. show less Download/Full Text The full text of this publication is not available. Version on publisher website for UU-students and staff Version on publisher website
No takes yet. Share an insight, caveat, or question.
Ponticelli et al. (2021) conducted an observational in Refractory angina (n=658). Coronary sinus Reducer (CSR) implantation was evaluated on Improvement by ≥2 CCS classes. Coronary sinus Reducer implantation resulted in an improvement of ≥2 CCS classes in 39.7% of patients with refractory angina at a median follow-up of 502 days.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: