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Review
. 2024 Jul 29;16(7):e65662.
doi: 10.7759/cureus.65662. eCollection 2024 Jul.

Evaluating the Efficacy of Coronary Sinus Reducer Implantation in the Management of Refractory Angina: A Systematic Review and Meta-Analysis

Gaurang H Suhagiya  1 , Yoseph L Herpo  2 , Darab Shuja  3 , Aqsa A Butt  4 , Muhammad Umar Mian  4 , Sandipkumar S Chaudhari  5   6 , Calvin R Wei  7 , Adil Amin  8
Affiliations
Review

Evaluating the Efficacy of Coronary Sinus Reducer Implantation in the Management of Refractory Angina: A Systematic Review and Meta-Analysis

Gaurang H Suhagiya et al. Cureus. .

Abstract

The coronary sinus reducer (CSR), a minimally invasive device, has emerged as a promising alternative for improving myocardial perfusion in these patients. This meta-analysis evaluated the effectiveness of CSR implantation in patients with refractory angina. A comprehensive search of PubMed, EMBASE, and Web of Science databases identified 10 relevant studies with a pooled sample size of 799 patients. The analysis focused on changes in the Canadian Cardiovascular Society (CCS) classification score, Seattle Angina Questionnaire (SAQ) score, and six-minute walk distance (6MWD) from baseline to follow-up. Results showed significant improvements across all measured outcomes. CCS scores decreased significantly post-CSR implantation, indicating reduced angina severity. SAQ scores improved across all domains, including physical limitation, anginal stability, anginal frequency, treatment satisfaction, and quality of life, suggesting enhanced overall well-being. The 6MWD also increased significantly, reflecting improved functional capacity. These findings highlight CSR's potential as an effective treatment option for patients with refractory angina who have exhausted traditional therapies. CSR implantation appears to alleviate angina symptoms, improve quality of life, and enhance exercise tolerance. Future research should prioritize larger, multi-center randomized controlled trials to validate these findings. Long-term follow-up studies are needed to assess sustained benefits and potential risks.

Keywords: coronary sinus reducer implantation; efficacy; refractory angina; symptoms; systematic review and meta-analysis.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flowchart showing the study selection process.
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2. Effect of CSR on change in CSS.
References [11-18]. CSR: coronary sinus reducer, CSS: Canadian Cardiovascular Society Classification Score.
Figure 3
Figure 3. Effect of CSR on 6MWD.
References [13,18,20]. CSR: coronary sinus reducer, 6MWD: six-minute walk distance.
See this image and copyright information in PMC

References

    1. Management of patients with refractory angina: Canadian Cardiovascular Society/Canadian Pain Society joint guidelines. McGillion M, Arthur HM, Cook A, et al. Can J Cardiol. 2012;28:0–41. - PubMed
    1. Fatality, morbidity and quality of life in patients with refractory angina pectoris. Andréll P, Ekre O, Grip L, et al. Int J Cardiol. 2011;147:377–382. - PubMed
    1. Refractory angina: from pathophysiology to new therapeutic nonpharmacological technologies. Gallone G, Baldetti L, Tzanis G, et al. JACC Cardiovasc Interv. 2020;13:1–19. - PubMed
    1. Coronary sinus reducer: a new hope for refractory angina? Monti CB, Palmisano A. The Lancet. 2024;403:1514–1515. - PubMed
    1. Coronary sinus reducer implantation in patients with refractory angina: first experience in Poland. Zimoch W, Kuliczkowski W, Reczuch K. Pol Heart J. 2021;79:471–472. - PubMed

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