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Noninvasive therapy for the management of patients with advanced coronary artery disease.
MedLine Citation:
PMID:  23011412     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To determine the efficacy of cardiac shock wave therapy (CSWT) in the management of patients with end-stage coronary artery disease (CAD). INTRODUCTION: Patients with end-stage CAD have symptoms such as recurrent angina, breathlessness, and other debilitating conditions. End-stage CAD patients are usually those who have angina pectoris following a coronary artery bypass surgery or a percutaneous coronary intervention. These patients are refractory to optimal medical therapy and not fit for a redo procedure, and are often termed as 'no option' patients. METHODS: We carried out a prospective cohort study to examine the effects of CSWT application in patients who had end-stage CAD and were no option patients. Characteristics such as angina class scores and functional status scores among cases (patients with end-stage CAD who received CSWT) and controls (patients with end-stage CAD who did not receive CSWT) were compared at baseline and at 6 months after CSWT therapy. RESULTS: There were 43 patients in the case group and 43 patients in the control group. The mean age of the patients was 58.7±9.5 years in the case group and 56.6±11.6 years in the control group. Other characteristics such as the prevalence of diabetes, hypertension, coronary artery bypass graft and percutaneous coronary intervention were similar in both groups. Clinical results showed a significant improvement in exercise time between the cases and the controls 6 months after treatment with CSWT (20.1±15.7 min in cases vs. 10.1±4.2 min in controls; P<0.0001), and symptomatic improvement in the CCS class scores (1.95±0.80 in cases and 2.63±0.69 in controls; P<0.0001) and NYHA class scores (1.95±0.80 in cases vs. 2.48±0.59 in controls; P<0.001). In the control group, there was no improvement in angina class, functional class and exercise time. CONCLUSION: The present study shows that CSWT application to the ischemic myocardium in patients with refractory angina pectoris improved symptoms and reduced the severity of ischemic areas at 6 months after CSWT treatment compared with the baseline. No side effects were observed with this therapy.
Authors:
Waqar H Kazmi; Syed Z Rasheed; Saeed Ahmed; Mohammad Saadat; Saqib Altaf; Abdus Samad
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-22
Journal Detail:
Title:  Coronary artery disease     Volume:  -     ISSN:  1473-5830     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aKarachi Medical and Dental College bKarachi Institute of Heart Diseases cUniversal Research Group (URG), Karachi, Pakistan.
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