Heider Hemeed Abbas , Ali Yahya Abdullah, Ahmed N. Rajeeb, Khalid I. Amber, Ahmed Nasir Machchi

Quality of life improvement after one year follow up in patients with refractory anginapectoris treated with enhanced external counter pulsation

Heider Hemeed Abbas , Ali Yahya Abdullah, Ahmed N. Rajeeb, Khalid I. Amber, Ahmed Nasir Machchi



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ABSTRACT

 

Background::  Refractory angina is usually portrayed as a prolonged state (equal or more than 3 months in duration) considered by angina in the coronary vascular disorder setting, which cannot be regulated by a consolidation of ideal therapeutic treatment, surgical cardiac intervention, and where reversible cardiac ischemia has been stated to be the reason for the manifestation clinically.

Aim: Safety use enhanced external counter pulsation in treating refractory angina pectoris and short term outcome.

Method: Eighty eight (88) patients with refractory angina pectoris un respond to treatment and/or intervention or unfit for intervention or surgery have been enrolled in this prospective, single arm cohort clinical study, symptomatic angina despite medication and/or intervention, for all ECG, echocardiography study done to assess LV and valvular function, Doppler study for lower limb artery to assess if there is peripheral vascular disease, abdominal ultrasound done to exclude the presence of aortic abdominal aneurysm, then if patient eligible for EECP inclusion criteria refer for EECP unit.

Results: Over 12 month’s period of the study, 88 persons were assessed including 26(30%) women and 62 (70%) men. The age range was 45 years to 80 years with the mean age range 61 years (SD ± 8.2).

We found statistically significant (p-value < 0.00001) change in symptom from CCS3 and CCS4 pre EECP to CCS1 and CCS2 post EECP. Also we observe that this change in CCS after EECP persist to 6 month and to lesser in 1 year but generally remain in CCS1 and CCS2 at end of 1 year which was also statistically significant (p-value < 0.00001) and we observe that not response appear in CCS4 and CCS3 patients where there improvement persist to the end of year.

Conclusion: EECP appear as safe effective therapy in selective patient with refractory angina not respond to medical and unfit for intervention or surgery. Response to EECP in well selected patient persist for 1 year 

Keywords: EECP, Refractory angina pectoris, Quality of life.



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