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经冠状窦减少器植入术治疗慢性难治性心绞痛的效果。

Usefulness of Coronary Sinus Reducer Implantation for the Treatment of Chronic Refractory Angina Pectoris.

机构信息

Department of Cardiology Thoracic and Vascular Sciences and Public Health, University of Padua, Italy.

Interventional Cardiology Unit, GVM Care & Research Maria Cecilia Hospital, Cotignola, Italy.

出版信息

Am J Cardiol. 2021 Jan 15;139:22-27. doi: 10.1016/j.amjcard.2020.09.045. Epub 2020 Sep 28.

Abstract

The coronary sinus (CS) Reducer is a novel device designed for the management of patients with severe angina symptoms refractory to optimal medical therapy and not amenable to further revascularization. Aim of this study was to investigate the efficacy and the safety of the CS Reducer device in a real-world, multicenter, and country-level cohort of patients presenting with refractory angina pectoris. The study included patients affected by refractory angina pectoris who underwent CS Reducer implantation in 16 centers. Clinical follow-up was carried as per each center's protocol. One hundred eighty-seven patients were included. Technical and procedural success were achieved in 98% and 95%, respectively. Minor peri-procedural complications were recorded in 8 patients. During a median follow-up of 18.4 months, 135 (82.8%) patients demonstrated at least 1 CCS class reduction after Reducer implantation, and 80 (49%) patients at least 2 CCS class reduction. Mean CCS class improved from 3.05 ± 0.53 at baseline to 1.63 ± 0.98 at follow-up (p < 0.001). Treatment benefit was also reflected in a significant improvement in quality of life scores and in a reduction of the mean number of anti-ischemic drugs prescribed for patient. In conclusion, in this multicenter, country-level study, the implantation of CS Reducer in patients with refractory angina pectoris resulted to be safe and effective in reducing of angina pectoris and improving quality of life.

摘要

冠状窦(CS)减容器是一种新型装置,专为严重心绞痛症状经最佳药物治疗无效且无法进一步血运重建的患者设计。本研究旨在探讨 CS 减容器装置在一个真实世界、多中心和国家级队列中治疗难治性心绞痛患者的疗效和安全性。该研究纳入了 16 个中心接受 CS 减容器植入的难治性心绞痛患者。临床随访按照每个中心的方案进行。共纳入 187 例患者。技术和程序成功率分别达到 98%和 95%。8 例患者记录到轻微围手术期并发症。在中位随访 18.4 个月期间,135 例(82.8%)患者在植入减容器后至少有 1 个 CCS 分级降低,80 例(49%)患者至少有 2 个 CCS 分级降低。CCS 分级从基线时的 3.05±0.53 平均改善至随访时的 1.63±0.98(p<0.001)。治疗获益还反映在生活质量评分的显著改善和抗缺血药物处方数量的减少。总之,在这项多中心、国家级研究中,CS 减容器在难治性心绞痛患者中的植入是安全有效的,可减轻心绞痛并改善生活质量。

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