New Device Implanted in Coronary Sinus May Improve Symptoms of Refractory Angina
A recent study published in the New
England Journal of Medicine (NEJM) has investigated the efficacy of a new
device designed to relive refractory angina in patients who suffer from
coronary artery disease. The device is implanted in the coronary sinus where it
increases pressure to relieve pain caused by angina.
104 patients at 11 different
clinical centers participated in this study. All patients were over 18 years of
age and had been diagnosed with class III or IV angina that had not improved
with existing therapies. Half of the participants had the device implanted
while the other half had a sham device implanted and served as the control
group. This study was double blind so neither participants themselves nor the
researchers (with the exception of the physicians who performed the implantations)
knew which participants were in which group. Over the course of 3 years,
researchers monitored patient angina by measuring cardiac wall motion and by
asking participants to rate their symptoms in a questionnaire.
Results showed significant improvement
in at least one angina class in 71% of the treatment group compared to only 42%
of the control group. 35% of treatment group participants further reported
improvement in 2 or more angina classes compared to 15% of control group
participants. Thus, the implantation of this device was associated with greater
relief from angina-related symptoms.
As heart disease rates and life
expectancies for patients with coronary heart disease rise in the Western
world, rates of refractory angina rise as well. It is thus vital to develop
improved therapies for the symptoms of angina, since many current treatments
are not very effective. However, despite its clinical importance, this study
was not without limitations. The study relied heavily on patient self-report and
the number of participants was relatively small (n = 104). Further studies are
needed to confirm the efficacy of the device and to understand its applications
on a wider scale, but for now this coronary sinus implantation device shows
promise as an effective treatment for refractory angina.
N Engl J Med. 2015;
372:519-527. doi: 10.1056/NEJMoa1402556.
Caroline
Russell-Troutman is the 2014-2015 Research Highlights Editor.
Posts
