Refractory angina (RA) is characterised by persistent anginal symptoms despite optimal medical therapy and revascularisation. Enhanced external counterpulsation (EECP) is a technique that has shown promise in the treatment of this condition but is poorly utilised in the UK. The aim of this study is to assess the effect of EECP on anginal symptoms in patients with RA from a UK centre.
This retrospective study assessed the effectiveness of EECP at improving exercise capacity, anginal symptom burden and anginal episode frequency using pre- and post-treatment six-minute walk test (6MWT) results, Canadian Cardiovascular Society (CCS) scores and symptom questionnaires, respectively.
Fifty patients with a median age of 67 years (interquartile range [IQR] 14) underwent EECP between 2004 and 2015. The majority had undergone prior revascularisation (84%; 42/50) via percutaneous coronary intervention (PCI) and/or coronary artery bypass grafting (CABG). Significant improvements were noted in 6MWT result (282 vs. 357 m; p<0.01), CCS score (3.2 vs. 2.0; p<0.01) and weekly anginal episode frequency (20 vs. 4; p<0.01). No adverse outcomes related to EECP were noted.
Our study demonstrates use of EECP to be associated with significant improvements in exercise capacity and anginal symptom burden.