Suhagiya Gaurang H, Herpo Yoseph L, Shuja Darab, Butt Aqsa A, Mian Muhammad Umar, Chaudhari Sandipkumar S, Wei Calvin R, Amin Adil
College of Medicine, Jiangsu University, Zhenjiang, CHN.
Internal Medicine, Hayat Medical College, Addis Ababa, ETH.
Cureus. 2024 Jul 29;16(7):e65662. doi: 10.7759/cureus.65662. eCollection 2024 Jul.
The coronary sinus reducer (CSR), a minimally invasive device, has emerged as a promising alternative for improving myocardial perfusion in these patients. This meta-analysis evaluated the effectiveness of CSR implantation in patients with refractory angina. A comprehensive search of PubMed, EMBASE, and Web of Science databases identified 10 relevant studies with a pooled sample size of 799 patients. The analysis focused on changes in the Canadian Cardiovascular Society (CCS) classification score, Seattle Angina Questionnaire (SAQ) score, and six-minute walk distance (6MWD) from baseline to follow-up. Results showed significant improvements across all measured outcomes. CCS scores decreased significantly post-CSR implantation, indicating reduced angina severity. SAQ scores improved across all domains, including physical limitation, anginal stability, anginal frequency, treatment satisfaction, and quality of life, suggesting enhanced overall well-being. The 6MWD also increased significantly, reflecting improved functional capacity. These findings highlight CSR's potential as an effective treatment option for patients with refractory angina who have exhausted traditional therapies. CSR implantation appears to alleviate angina symptoms, improve quality of life, and enhance exercise tolerance. Future research should prioritize larger, multi-center randomized controlled trials to validate these findings. Long-term follow-up studies are needed to assess sustained benefits and potential risks.
冠状动脉窦减压器（CSR）是一种微创设备，已成为改善这些患者心肌灌注的一种有前景的替代方法。这项荟萃分析评估了CSR植入术在难治性心绞痛患者中的有效性。对PubMed、EMBASE和Web of Science数据库进行全面检索后，确定了10项相关研究，汇总样本量为799例患者。该分析重点关注从基线到随访期间加拿大心血管学会（CCS）分类评分、西雅图心绞痛问卷（SAQ）评分以及六分钟步行距离（6MWD）的变化。结果显示，所有测量结果均有显著改善。CSR植入术后CCS评分显著降低，表明心绞痛严重程度减轻。SAQ评分在所有领域均有所改善，包括身体限制、心绞痛稳定性、心绞痛发作频率、治疗满意度和生活质量，表明整体幸福感增强。6MWD也显著增加，反映了功能能力的改善。这些发现突出了CSR作为难治性心绞痛患者有效治疗选择的潜力，这些患者已用尽传统疗法。CSR植入术似乎可以缓解心绞痛症状、改善生活质量并提高运动耐量。未来的研究应优先开展更大规模的多中心随机对照试验，以验证这些发现。需要进行长期随访研究，以评估持续获益和潜在风险。
