AIMS: Refractory angina pectoris leads to significant morbidity. Treatment options include percutaneous myocardial laser revascularization (PMR) and spinal cord stimulation (SCS). This study was designed to compare these two treatments. METHODS AND RESULTS: Subjects with Canadian Cardiovascular Society (CCS) class 3/4 angina and reversible perfusion defects were randomized to SCS (34) or PMR (34). The primary outcome was to compare exercise treadmill time on a modified Bruce protocol over 12 months. Thirty subjects in both groups completed 12-month follow-up. The mean total exercise time was 6.38 +/- 3.45 min in the SCS group and 7.41+/-3.68 min in the PMR group at baseline and 7.08 +/- 0.67 min in the SCS group and 7.12 +/-0.71 min in the PMR group at 12 months (95% confidence limits for the difference between the groups -1.02 to + 2.2 min, P = 0.466). There were no differences in angina-free exercise capacity, CCS class, and quality of life between treatments. SCS patients had more adverse events in the first 12 months, mainly angina or SCS system related (P = 0.001). CONCLUSION: There was little evidence of a difference in effectiveness between SCS and PMR in patients with refractory angina.
RCT Entities:
AIMS: Refractory angina pectoris leads to significant morbidity. Treatment options include percutaneous myocardial laser revascularization (PMR) and spinal cord stimulation (SCS). This study was designed to compare these two treatments. METHODS AND RESULTS: Subjects with Canadian Cardiovascular Society (CCS) class 3/4 angina and reversible perfusion defects were randomized to SCS (34) or PMR (34). The primary outcome was to compare exercise treadmill time on a modified Bruce protocol over 12 months. Thirty subjects in both groups completed 12-month follow-up. The mean total exercise time was 6.38 +/- 3.45 min in the SCS group and 7.41+/-3.68 min in the PMR group at baseline and 7.08 +/- 0.67 min in the SCS group and 7.12 +/-0.71 min in the PMR group at 12 months (95% confidence limits for the difference between the groups -1.02 to + 2.2 min, P = 0.466). There were no differences in angina-free exercise capacity, CCS class, and quality of life between treatments. SCS patients had more adverse events in the first 12 months, mainly angina or SCS system related (P = 0.001). CONCLUSION: There was little evidence of a difference in effectiveness between SCS and PMR in patients with refractory angina.
Authors: Mohammed Qintar; John A Spertus; Kensey L Gosch; John Beltrame; Faraz Kureshi; Ali Shafiq; Tracie Breeding; Karen P Alexander; Suzanne V Arnold Journal: Eur Heart J Qual Care Clin Outcomes Date: 2016-03-25
Authors: Sam Eldabe; John Raphael; Simon Thomson; Andrea Manca; Mark de Belder; Rajesh Aggarwal; Matthew Banks; Morag Brookes; Susan Merotra; Rashidat Adeniba; Ed Davies; Rod S Taylor Journal: Trials Date: 2013-02-22 Impact factor: 2.279
Authors: Michael McGillion; Allison Cook; J Charles Victor; Sandra Carroll; Julie Weston; Kevin Teoh; Heather M Arthur Journal: Vasc Health Risk Manag Date: 2010-09-07
Authors: Kimberley A Goldsmith; Matthew T Dyer; Martin J Buxton; Linda D Sharples Journal: Health Qual Life Outcomes Date: 2010-06-04 Impact factor: 3.186
Authors: Kimberley A Goldsmith; Matthew T Dyer; Peter M Schofield; Martin J Buxton; Linda D Sharples Journal: Health Qual Life Outcomes Date: 2009-11-26 Impact factor: 3.186