The number of patients with severe CAD is increasing because of improved survival rates and an aging population. The authors concluded that the coronary sinus reducing device led to a reduction in symptoms and improved quality of life in patients with disabling angina pectoris. CT angiography six months after device implantation was performed in 72% (36/50) confirming no device migration or occlusion. A peri-procedural myocardial infarction occurred in one patient in the treatment group. There were no statistically significant differences for other endpoints including angina stability and frequency, exercise duration, change in the time to ST-segment depression of 1 mm, or change in the wall-motion index according to dobutamine stress echocardiography. A similar improvement was observed in Quality of Life Index (17.6/100 vs. There was an improvement of at least one CCS angina class in the treatment group (71% vs. Improvement by at least two CCS angina classes was noted in 35% of the treatment group compared to 15% of the control group ( p =.

Successful device implantation was accomplished in 96% of the participants. Mean age of the participants was 67.8 years, 81% were men, 84% with CCS angina class 3, and about three-quarters had previous CABG and/or PCI. The primary end point was improvement by at least two CCS angina classes at six months. Patients were randomized to device implantation (treatment group) or to a sham procedure (control group). This was a randomized, double-blind, sham-controlled clinical trial conducted at 11 centers and included 104 patients who had Canadian Cardiovascular Society (CCS) class III or IV angina and evidence of reversible myocardial ischemia despite medical therapy for at least 30 days before screening.

In this study, the safety and efficacy of the Coronary Sinus Reducer was evaluated in patients with refractory angina on optimal medical therapy who were not candidates for revascularization.

Percutaneous reduction of the coronary sinus is an emerging treatment for myocardial ischemia that increases coronary sinus pressure to reduce myocardial ischemia by redistribution of blood from non-ischemic to ischemic myocardium. Backgroundĭespite improvements in medical and surgical treatments of coronary artery disease, there remains a relatively large number of patients with refractory angina. Efficacy of a Device to Narrow the Coronary Sinus in Refractory Angina. Editor's Note: Commentary based on Verheye S, Jolicœur EM, Behan MW, et al.

Class iii angina