Predictors of treatment benefits after enhanced external counterpulsation in patients with refractory angina pectoris
Background Enhanced external counterpulsation (EECP) is a noninvasive treatment that can decrease limiting symptoms in patients with refractory angina pectoris (RAP). Identifying responders to EECP is important as EECP is not widely available and relatively time intensive. Hypothesis The effect of E...
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| Veröffentlicht in: | Clinical cardiology (Mahwah, N.J.) N.J.), 2021-02, Vol.44 (2), p.160-167 |
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| creator | Wu, Eline Mårtensson, Jan Desta, Liyew Broström, Anders |
| description | Background
Enhanced external counterpulsation (EECP) is a noninvasive treatment that can decrease limiting symptoms in patients with refractory angina pectoris (RAP). Identifying responders to EECP is important as EECP is not widely available and relatively time intensive.
Hypothesis
The effect of EECP treatment on physical capacity in patients with RAP can be predicted from baseline patient characteristics and clinical factors.
Methods
This explorative study includes all patients from a cardiology clinic who had finished one EECP treatment and a 6 min walk test pre and post EECP. Clinical data, including Canadian Cardiovascular Society (CCS) classification and left ventricular ejection fraction (LVEF), were assessed before treatment. If patients increased their 6 min walking distance (6MWD) by 10% post EECP, they were considered responders.
Results
Of the 119 patients (men = 97, 40–91 years), 49 (41.2%) were responders. Multinomial regression analysis showed that functional status (i.e., CCS class ≥3) (OR 3.10, 95% CI 1.12–8.57), LVEF |
| doi_str_mv | 10.1002/clc.23516 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_465415</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2484767464</sourcerecordid><originalsourceid>FETCH-LOGICAL-c6056-d50caae30a57b1926dd568dd4ba500922a78efdb9ef91102fa3eee13ef6a019c3</originalsourceid><addsrcrecordid>eNqFkk1v1DAQhiMEotvCgT-ALHGhQmn9ETvxBalaPqWV4ABcLceZ7HrJ2sFOWPbf45BtoUiFk2fsZ9555Zkse0LwBcGYXprOXFDGibiXLYhkNK9KVt7PFpgInEtayZPsNMZtQnFF2cPshLEiJZIusvFjgMaawYeIfIuGAHrYgRtQDQ5aO0Sk2wECArfRzkCD4EdKne6Q8aNLYT92UQ_WO2Qd6lOUiiPa22GDArRBT9IHpN3aOo16mFIbH2UPWt1FeHw8z7LPb15_Wr7LVx_evl9erXIjMBd5w7HRGhjWvKyJpKJpuKiapqg1x1hSqssK2qaW0EpCMG01AwDCoBUaE2nYWZbPunEP_VirPtidDgfltVXHq68pAlUIXhCeeHkn3wff_C66LiQF58krE__s9cp-uVI-rFVnR0VKKqup14v_85ut4oSLSf3lTCd0B41Jvxx0d9vgrRdnN2rtv6uy4jR1TALPjwLBfxshDmpno4Gu0w78GBUtSl5gSkiV0Gd_oVs_TjOfqKooRVmIIlHnM2WCjzHN-sYMwWpaS5XWUv1ay8Q-_dP9DXm9hwm4nIG97eBwt5Jarpaz5E-DKvHs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2484767464</pqid></control><display><type>article</type><title>Predictors of treatment benefits after enhanced external counterpulsation in patients with refractory angina pectoris</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><source>NCBI_PubMed Central（免费）</source><source>Wiley Online Library Open Access</source><source>DOAJ Directory of Open Access Journals</source><source>Free E-Journal (出版社公開部分のみ）</source><source>SWEPUB Freely available online</source><creator>Wu, Eline ; Mårtensson, Jan ; Desta, Liyew ; Broström, Anders</creator><creatorcontrib>Wu, Eline ; Mårtensson, Jan ; Desta, Liyew ; Broström, Anders</creatorcontrib><description>Background
Enhanced external counterpulsation (EECP) is a noninvasive treatment that can decrease limiting symptoms in patients with refractory angina pectoris (RAP). Identifying responders to EECP is important as EECP is not widely available and relatively time intensive.
Hypothesis
The effect of EECP treatment on physical capacity in patients with RAP can be predicted from baseline patient characteristics and clinical factors.
Methods
This explorative study includes all patients from a cardiology clinic who had finished one EECP treatment and a 6 min walk test pre and post EECP. Clinical data, including Canadian Cardiovascular Society (CCS) classification and left ventricular ejection fraction (LVEF), were assessed before treatment. If patients increased their 6 min walking distance (6MWD) by 10% post EECP, they were considered responders.
Results
Of the 119 patients (men = 97, 40–91 years), 49 (41.2%) were responders. Multinomial regression analysis showed that functional status (i.e., CCS class ≥3) (OR 3.10, 95% CI 1.12–8.57), LVEF <50% (OR 2.82, 95% CI 1.02–7.80), and prior performed revascularization (i.e., ≤ 1 type of intervention) (OR 2.77, 95% CI 1.06–7.20) were predictors of response to EECP (p < .05, Accuracy 63.6%). Traditional risk factors (e.g., gender, smoking, and comorbidities) did not predict response.
Conclusions
EECP treatment should be considered preferentially for patients that have a greater functional impairment, evidence of systolic left ventricular dysfunction, and exposure to fewer types of revascularization, either PCI or CABG. Improvement in 6MWD post EECP could imply improvement in physical capacity, which is a likely contributor to improved well‐being among patients with RAP.</description><identifier>ISSN: 0160-9289</identifier><identifier>ISSN: 1932-8737</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.23516</identifier><identifier>PMID: 33400292</identifier><language>eng</language><publisher>New York: Wiley Periodicals, Inc</publisher><subject>Angina pectoris ; Angina Pectoris - diagnosis ; Angina Pectoris - therapy ; Canada ; Cardiovascular disease ; Clinical Investigations ; Coronary vessels ; Counterpulsation ; Diabetes ; Ethics ; Follow-Up Studies ; Humans ; Hypertension ; Male ; Medicin och hälsovetenskap ; Pain ; Patients ; Percutaneous Coronary Intervention ; Sociodemographics ; Statistical analysis ; Stroke Volume ; Treatment Outcome ; Variables ; Ventricular Function, Left ; Well being</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 2021-02, Vol.44 (2), p.160-167</ispartof><rights>2020 The Authors. published by Wiley Periodicals LLC.</rights><rights>2020 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.</rights><rights>2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6056-d50caae30a57b1926dd568dd4ba500922a78efdb9ef91102fa3eee13ef6a019c3</citedby><cites>FETCH-LOGICAL-c6056-d50caae30a57b1926dd568dd4ba500922a78efdb9ef91102fa3eee13ef6a019c3</cites><orcidid>0000-0002-5534-7541</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7852172/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7852172/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,552,727,780,784,864,885,1417,11562,27924,27925,45574,45575,46052,46476,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33400292$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-51566$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-172985$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:145560536$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Eline</creatorcontrib><creatorcontrib>Mårtensson, Jan</creatorcontrib><creatorcontrib>Desta, Liyew</creatorcontrib><creatorcontrib>Broström, Anders</creatorcontrib><title>Predictors of treatment benefits after enhanced external counterpulsation in patients with refractory angina pectoris</title><title>Clinical cardiology (Mahwah, N.J.)</title><addtitle>Clin Cardiol</addtitle><description>Background
Enhanced external counterpulsation (EECP) is a noninvasive treatment that can decrease limiting symptoms in patients with refractory angina pectoris (RAP). Identifying responders to EECP is important as EECP is not widely available and relatively time intensive.
Hypothesis
The effect of EECP treatment on physical capacity in patients with RAP can be predicted from baseline patient characteristics and clinical factors.
Methods
This explorative study includes all patients from a cardiology clinic who had finished one EECP treatment and a 6 min walk test pre and post EECP. Clinical data, including Canadian Cardiovascular Society (CCS) classification and left ventricular ejection fraction (LVEF), were assessed before treatment. If patients increased their 6 min walking distance (6MWD) by 10% post EECP, they were considered responders.
Results
Of the 119 patients (men = 97, 40–91 years), 49 (41.2%) were responders. Multinomial regression analysis showed that functional status (i.e., CCS class ≥3) (OR 3.10, 95% CI 1.12–8.57), LVEF <50% (OR 2.82, 95% CI 1.02–7.80), and prior performed revascularization (i.e., ≤ 1 type of intervention) (OR 2.77, 95% CI 1.06–7.20) were predictors of response to EECP (p < .05, Accuracy 63.6%). Traditional risk factors (e.g., gender, smoking, and comorbidities) did not predict response.
Conclusions
EECP treatment should be considered preferentially for patients that have a greater functional impairment, evidence of systolic left ventricular dysfunction, and exposure to fewer types of revascularization, either PCI or CABG. Improvement in 6MWD post EECP could imply improvement in physical capacity, which is a likely contributor to improved well‐being among patients with RAP.</description><subject>Angina pectoris</subject><subject>Angina Pectoris - diagnosis</subject><subject>Angina Pectoris - therapy</subject><subject>Canada</subject><subject>Cardiovascular disease</subject><subject>Clinical Investigations</subject><subject>Coronary vessels</subject><subject>Counterpulsation</subject><subject>Diabetes</subject><subject>Ethics</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Male</subject><subject>Medicin och hälsovetenskap</subject><subject>Pain</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention</subject><subject>Sociodemographics</subject><subject>Statistical analysis</subject><subject>Stroke Volume</subject><subject>Treatment Outcome</subject><subject>Variables</subject><subject>Ventricular Function, Left</subject><subject>Well being</subject><issn>0160-9289</issn><issn>1932-8737</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>D8T</sourceid><recordid>eNqFkk1v1DAQhiMEotvCgT-ALHGhQmn9ETvxBalaPqWV4ABcLceZ7HrJ2sFOWPbf45BtoUiFk2fsZ9555Zkse0LwBcGYXprOXFDGibiXLYhkNK9KVt7PFpgInEtayZPsNMZtQnFF2cPshLEiJZIusvFjgMaawYeIfIuGAHrYgRtQDQ5aO0Sk2wECArfRzkCD4EdKne6Q8aNLYT92UQ_WO2Qd6lOUiiPa22GDArRBT9IHpN3aOo16mFIbH2UPWt1FeHw8z7LPb15_Wr7LVx_evl9erXIjMBd5w7HRGhjWvKyJpKJpuKiapqg1x1hSqssK2qaW0EpCMG01AwDCoBUaE2nYWZbPunEP_VirPtidDgfltVXHq68pAlUIXhCeeHkn3wff_C66LiQF58krE__s9cp-uVI-rFVnR0VKKqup14v_85ut4oSLSf3lTCd0B41Jvxx0d9vgrRdnN2rtv6uy4jR1TALPjwLBfxshDmpno4Gu0w78GBUtSl5gSkiV0Gd_oVs_TjOfqKooRVmIIlHnM2WCjzHN-sYMwWpaS5XWUv1ay8Q-_dP9DXm9hwm4nIG97eBwt5Jarpaz5E-DKvHs</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Wu, Eline</creator><creator>Mårtensson, Jan</creator><creator>Desta, Liyew</creator><creator>Broström, Anders</creator><general>Wiley Periodicals, Inc</general><general>John Wiley & Sons, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>AABRY</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>D8X</scope><scope>ZZAVC</scope><scope>ABXSW</scope><scope>DG8</scope><orcidid>https://orcid.org/0000-0002-5534-7541</orcidid></search><sort><creationdate>202102</creationdate><title>Predictors of treatment benefits after enhanced external counterpulsation in patients with refractory angina pectoris</title><author>Wu, Eline ; Mårtensson, Jan ; Desta, Liyew ; Broström, Anders</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6056-d50caae30a57b1926dd568dd4ba500922a78efdb9ef91102fa3eee13ef6a019c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Angina pectoris</topic><topic>Angina Pectoris - diagnosis</topic><topic>Angina Pectoris - therapy</topic><topic>Canada</topic><topic>Cardiovascular disease</topic><topic>Clinical Investigations</topic><topic>Coronary vessels</topic><topic>Counterpulsation</topic><topic>Diabetes</topic><topic>Ethics</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Male</topic><topic>Medicin och hälsovetenskap</topic><topic>Pain</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention</topic><topic>Sociodemographics</topic><topic>Statistical analysis</topic><topic>Stroke Volume</topic><topic>Treatment Outcome</topic><topic>Variables</topic><topic>Ventricular Function, Left</topic><topic>Well being</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Eline</creatorcontrib><creatorcontrib>Mårtensson, Jan</creatorcontrib><creatorcontrib>Desta, Liyew</creatorcontrib><creatorcontrib>Broström, Anders</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley-Blackwell Open Access Backfiles</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SWEPUB Högskolan i Jönköping full text</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SWEPUB Högskolan i Jönköping</collection><collection>SwePub Articles full text</collection><collection>SWEPUB Linköpings universitet full text</collection><collection>SWEPUB Linköpings universitet</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Eline</au><au>Mårtensson, Jan</au><au>Desta, Liyew</au><au>Broström, Anders</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of treatment benefits after enhanced external counterpulsation in patients with refractory angina pectoris</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><addtitle>Clin Cardiol</addtitle><date>2021-02</date><risdate>2021</risdate><volume>44</volume><issue>2</issue><spage>160</spage><epage>167</epage><pages>160-167</pages><issn>0160-9289</issn><issn>1932-8737</issn><eissn>1932-8737</eissn><abstract>Background
Enhanced external counterpulsation (EECP) is a noninvasive treatment that can decrease limiting symptoms in patients with refractory angina pectoris (RAP). Identifying responders to EECP is important as EECP is not widely available and relatively time intensive.
Hypothesis
The effect of EECP treatment on physical capacity in patients with RAP can be predicted from baseline patient characteristics and clinical factors.
Methods
This explorative study includes all patients from a cardiology clinic who had finished one EECP treatment and a 6 min walk test pre and post EECP. Clinical data, including Canadian Cardiovascular Society (CCS) classification and left ventricular ejection fraction (LVEF), were assessed before treatment. If patients increased their 6 min walking distance (6MWD) by 10% post EECP, they were considered responders.
Results
Of the 119 patients (men = 97, 40–91 years), 49 (41.2%) were responders. Multinomial regression analysis showed that functional status (i.e., CCS class ≥3) (OR 3.10, 95% CI 1.12–8.57), LVEF <50% (OR 2.82, 95% CI 1.02–7.80), and prior performed revascularization (i.e., ≤ 1 type of intervention) (OR 2.77, 95% CI 1.06–7.20) were predictors of response to EECP (p < .05, Accuracy 63.6%). Traditional risk factors (e.g., gender, smoking, and comorbidities) did not predict response.
Conclusions
EECP treatment should be considered preferentially for patients that have a greater functional impairment, evidence of systolic left ventricular dysfunction, and exposure to fewer types of revascularization, either PCI or CABG. Improvement in 6MWD post EECP could imply improvement in physical capacity, which is a likely contributor to improved well‐being among patients with RAP.</abstract><cop>New York</cop><pub>Wiley Periodicals, Inc</pub><pmid>33400292</pmid><doi>10.1002/clc.23516</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5534-7541</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley-Blackwell Journals; MEDLINE; NCBI_PubMed Central（免费）; Wiley Online Library Open Access; DOAJ Directory of Open Access Journals; Free E-Journal (出版社公開部分のみ）; SWEPUB Freely available online |
| subjects | Angina pectoris Angina Pectoris - diagnosis Angina Pectoris - therapy Canada Cardiovascular disease Clinical Investigations Coronary vessels Counterpulsation Diabetes Ethics Follow-Up Studies Humans Hypertension Male Medicin och hälsovetenskap Pain Patients Percutaneous Coronary Intervention Sociodemographics Statistical analysis Stroke Volume Treatment Outcome Variables Ventricular Function, Left Well being |
| title | Predictors of treatment benefits after enhanced external counterpulsation in patients with refractory angina pectoris |
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