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REDUCER, the new kid on the block for refractory angina therapy - a single center experience
Session:
Painel 11 - Cardiologia Intervenção 4
Speaker:
Catarina Brízido
Congress:
CPC 2020
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.3 Non-coronary Cardiac Intervention
Session Type:
Posters
FP Number:
---
Authors:
Catarina Brízido; Sérgio Madeira; Mariana Gonçalves; João Brito; Luís Raposo ; Afonso Félix De Oliveira; Sílvio Leal; NELSON VALE; Pedro de Araújo Gonçalves; Henrique Gabriel; Rui Campante Teles; Manuel Almeida; Miguel Mendes
Abstract
<p><strong>Introduction</strong></p> <p>The coronary sinus Reducer emerged as a complementary therapy in patients with severe angina symptoms refractory to optimal medical therapy and not amenable to revascularization. The aim of this study was to assess the safety and efficacy of the Reducer in a real-world cohort of patients presenting with refractory angina.</p> <p><strong>Methods and population</strong></p> <p>Thirteen patients with refractory angina, objective evidence of myocardial ischemia attributable to the left coronary artery and deemed unsuitable for revascularization were treated with Reducer at a single center between April 2018 and June 2019.</p> <p>Safety endpoints were procedural success and complications. Efficacy endpoints, assessed at 6-month follow-up, were reduction in Canadian Cardiovascular Society angina (CCS) class, improvement in quality of life assessed by the Seattle Angina Questionnaire (SAQ) and reduction in pharmacological antianginal therapy.</p> <p><strong>Results</strong></p> <p>Ten patients (77%) had end-stage coronary artery disease without revascularization targets (previous CABG ± PCI in 8 and previous PCI in 2) and 3 patients had microvascular disease without epicardial stenosis. </p> <p>Procedural success was achieved in all patients, with no device related complications. There was one cardiac tamponade, promptly treated with pericardiocentesis.</p> <p>Regarding the efficacy endpoint, 10 patients (77%) had a reduction of at least one CCS class, 7 patients (54%) at least two classes, and 4 patients (31%) became asymptomatic, with a significant CCS class reduction from 3 [IQR 2-3] to 1 [IQR 0-2] (p=0.004) at 6-month follow-up. Concerning SAQ, there was a significant improvement in ability to perform physical activities (p= 0.04), angina frequency (p= 0.003), satisfaction with current angina treatment (p= 0.004) and enjoyment of life (p= 002). Seven patients (54%) had at least 1 antianginal drug reduction.</p> <p>There was no significant change in symptom status between 6 months and 1 year for those patients who completed 1-year follow-up.</p> <p><strong>Conclusion</strong></p> <p>In this real-world, single-center experience, implantation of Reducer was safe and associated with improvement of angina and quality of life in patients with refractory angina unsuitable for revascularization.</p>
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