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. 2023 Mar 20:45:101194.
doi: 10.1016/j.ijcha.2023.101194. eCollection 2023 Apr.

Long-term efficacy and safety of spinal cord stimulation in patients with refractory angina pectoris

F E Vervaat  1 , A van der Gaag  2 , K Teeuwen  1 , H van Suijlekom  2 , L Dekker  1 , I F Wijnbergen  1
Affiliations

Long-term efficacy and safety of spinal cord stimulation in patients with refractory angina pectoris

F E Vervaat et al. Int J Cardiol Heart Vasc. .

Abstract

Background: The number of patients with refractory angina pectoris (RAP), associated with poor quality of life, has been steadily increasing. Spinal cord stimulation (SCS) is a last resort treatment option leading to significant improvement in quality of life over a one year follow-up. The aim of this prospective, single-centre, observational cohort study is to determine the long-term efficacy and safety of SCS in patients with RAP.

Methods: All patients with RAP who received a spinal cord stimulator from the period July 2010 up to November 2019 were included. In May 2022 all patients were screened for long-term follow-up. If the patient was alive the Seattle Angina (SAQ) and RAND-36 questionnaire were completed and if the patient had passed away cause of death was determined. The primary endpoint is the change in SAQ summary score at long-term follow-up compared to baseline.

Results: From July 2010 up to November 2019 132 patients received a spinal cord stimulator due to RAP. The mean follow-up period was 65.2 ± 32.8 months. Seventy-one patients completed the SAQ at baseline and long-term follow-up. The SAQ SS showed an improvement of 24.32U (95% confidence interval [CI]: 18.71 - 29.93; p < 0.001).

Conclusions: The main findings of the study show that long-term SCS in patients with RAP leads to significant improvement in quality of life, significant reduction in angina frequency, significantly less use of short-acting nitrates and a low risk of spinal cord stimulator related complications over a mean follow-up period of 65.2 ± 32.8 months.

Keywords: Coronary artery disease; Refractory angina pectoris; Spinal cord stimulation.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of patient selection.
Fig. 2
Fig. 2
A. use of short-acting nitrates b. angina pectoris frequency – at baseline and at long-term follow-up. range 1 to 6; 1 = more than four times per day, 2 = one to three times per day, 3 = more than three times per week, 4 = one to two times per week, 5 = less than one time per week, 6 = no use of short-acting nitrate (a) / no angina pectoris episodes (b). Fig. 2: a. Use of short-acting nitrates b. Angina pectoris frequency – at baseline and at long-term follow-up.
See this image and copyright information in PMC

References

    1. Mannheimer C., et al. The problem of chronic refractory angina. Report from the ESC Joint Study Group on the Treatment of Refractory Angina. Eur Heart J. 2002;23:355–370. - PubMed
    1. Gallone G., et al. Refractory Angina: From Pathophysiology to New Therapeutic Nonpharmacological Technologies. JACC Cardiovasc Interv. 2020;13:1–19. - PubMed
    1. Henry T.D., et al. Long-term survival in patients with refractory angina. Eur Heart J. 2013;34:2683–2688. - PubMed
    1. Knuuti, J. et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). Eur Heart J41, 407–477 (2020). - PubMed
    1. Latif O.A., Nedeukovic S.S., Stevenson L.W. Spinal cord stimulation for chronic intractable angina pectoris: A unified theory on its mechanism. Clin Cardiol. 2001;24:533–541. - PMC - PubMed

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