Unit of Cardiovascular Interventions, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Department of Cardiology, University of Turin, Turin, Italy.
Int J Cardiol. 2019 Oct 1;292:87-90. doi: 10.1016/j.ijcard.2019.05.026. Epub 2019 May 20.
Coronary Sinus Reducer emerged as promising therapeutic option for patients with refractory angina. While recent literature reports short-term benefits of Reducer implantation, there is paucity of evidence regarding its safety and efficacy at longer follow-up.
In the original cohort of 50 refractory angina patients treated with Reducer at San Raffaele Hospital (Milan, Italy) between March 2015 and August 2016, we reassessed angina symptoms, quality of life and recorded adverse events at 2-year (mean ± SD: 748 ± 84 days) follow-up.
Canadian Cardiovascular Society (CCS) score improved of ≥1 class in 34 patients (75.6%), and of ≥2 classes in 16 patients (35.6%), translating into a significant mean CCS score reduction at 2-year follow-up (1.74 ± 0.86 vs. 2.98 ± 0.52; p < 0.001). Four out of five Seattle Angina Questionnaire items improved significantly (p < 0.001 for all). Ten patients (22%) underwent percutaneous coronary intervention (PCI) during follow-up, three for acute coronary syndromes. Five patients died, two for cardiovascular causes (stroke and cardiac arrest).
Safety and efficacy observed in the short follow-up period after Reducer implantation are maintained at two years. Ten patients underwent PCI during follow-up, underlining that Reducer does not affect coronary artery disease progression.
冠状窦缩减器已成为治疗难治性心绞痛患者的有前途的治疗选择。虽然最近的文献报告了植入缩减器的短期益处,但在更长的随访时间内,其安全性和有效性的证据有限。
在 2015 年 3 月至 2016 年 8 月期间,在意大利米兰的圣拉斐尔医院接受 Reducer 治疗的 50 例难治性心绞痛患者的原始队列中,我们在 2 年(平均±SD:748±84 天)随访时重新评估了心绞痛症状、生活质量,并记录了不良事件。
34 名患者(75.6%)的加拿大心血管学会(CCS)评分提高了≥1 级,16 名患者(35.6%)的评分提高了≥2 级,这意味着 CCS 评分在 2 年随访时显著降低(1.74±0.86 与 2.98±0.52;p<0.001)。西雅图心绞痛问卷的五项中有四项显著改善(所有项目 p<0.001)。10 名患者(22%)在随访期间接受了经皮冠状动脉介入治疗(PCI),其中 3 名因急性冠状动脉综合征而接受治疗。5 名患者死亡,2 名死于心血管原因(中风和心脏骤停)。
在 Reducer 植入后短期随访中观察到的安全性和疗效在两年后得以维持。10 名患者在随访期间接受了 PCI,这表明 Reducer 不会影响冠状动脉疾病的进展。