SPC365

Coronary sinus reducer device for the treatment of refractory angina therapy. A multicentric initial experience.

Session: Comunicações Orais (Sessão 6) - DAC e Cuidados Intensivos 2 - Vários Tópicos
Speaker: João Pedro Dias Ferreira Reis

Congress: CPC 2022
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 12. Coronary Artery Disease (Chronic)
Subtheme: 12.4 Coronary Artery Disease – Treatment
Session Type: Comunicações Orais
FP Number: ---
Authors: João Pedro Reis; Catarina Brizido; Sérgio Madeira; Rúben Ramos; Manuel Almeida; Duarte Cacela

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Introduction</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">The coronary sinus Reducer </span></span><span style="font-family:&quot;Times New Roman&quot;,serif">device (CSRD) <span style="color:black">emerged as a complementary therapy in patients with severe angina refractory to optimal medical therapy and not amenable to revascularization. Our aim was to assess the safety and efficacy of the </span>CSRD<span style="color:black"> in a real-world setting.</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Methods</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Twenty-six patients with refractory angina (RA), evidence of myocardial ischemia attributable to the left coronary artery unsuitable&nbsp;for revascularization were treated with </span></span><span style="font-family:&quot;Times New Roman&quot;,serif">the CSRD<span style="color:black"> at two centres between May 2017 and July 2019. Safety endpoints were procedural success and complications. Efficacy endpoints, assessed at 6-month follow-up, were a reduction in CCS class, improvement in quality of life (QoL) assessed using </span></span><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">the short version of the Seattle Angina Questionnaire (SAQ-7)</span></span><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black"> and reduction in anti-anginal therapy.</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Results</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Twenty-three<strong> </strong>patients<strong> </strong>had end-stage CAD without revascularization targets and 3 patients had microvascular disease without epicardial stenosis. Procedural success was achieved 23 patients, with 2 device/procedural-related complications and one anatomically-related failure to deliver the device. Ultimately 25 patients implanted the device and entered the efficacy analysis. Eighteen<strong> </strong>patients (75.0%) had at least 1 reduction in CCS class, 41.7% had at least 2 class reductions, and 16.7% became asymptomatic, with a mean reduction of CCS class of 1.3&plusmn;0.2 (p=0.001) at 6-month follow-up. All SAQ-7 domains improved, namely physical limitation (p=0.001), angina frequency (p=0.005) and QoL (p=0.006). There was a mean reduction of anti-ischemic drugs from<strong> </strong>3.4&plusmn;1.1 to 2.9&plusmn;1.2 (p=0.010).</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">Conclusion</span></span></strong></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="color:black">In this real-world, multicentric experience, implantation of the </span></span><span style="font-family:&quot;Times New Roman&quot;,serif">CSRD<span style="color:black"> was associated with improvement of angina and QoL in patients with RA.</span></span></span></span></p>