Coronary Sinus Reduction for REDUCER-I Patients With Refractory Angina and Angiographically Nonobstructive Coronary Artery Disease | JACC: Advances

0:00Andashan Brambat, podcast editor for the Jack advances team. In the April 2006 issue, the study, coronary sinus reducer for reducer-1 patients with refractory angina and angiographically non-obstructive coronary artery disease, is by first orthodontic silver of the National Heart and Lung Institute Imperial College London, United Kingdom, and senior orthodontic verte, from the ZAS, Midalheim, Hospital, Antwerp, Belgium. Students with angiographically non-obstructive coronary artery disease, or angiocad, including those of previously successful re-vascularization, often experienced refractory angina. The objective of this study was to assess the efficacy of coronary sinus reducer for the treatment of patients with angiocad and no further re-vascularization options. The reducer-1 registry is a non-randomized, real-world observational study of patients with

1:00refractory angina, objective evidence of ischemia on non-invasive stress testing, and with no further re-vascularization options. Angiocad was defined as less than 70% stenosis by visual adjudication in all major epicardial coronary arteries at the time of enrollment. Twelve month outcomes included Canadian cardiovascular society class, Seattle angina questionnaire, and major adverse events. Of the 371 patients who received a coronary sinus reducer implant, 306 reported baseline coronary artery disease type, with 61 out of 306 or 19.9% having angiocad and 245 of 76, 80.1% having obstructive coronary artery disease. Both groups had similar baseline characteristics, although the angiocad patients were younger, aged 65.8 years, versus 70.2 years, had less prior coronary artery bypass grafting, 44%

2:05versus 80% and more prior percutaneous coronary intervention, 44% versus 72%, than patients with obstructive coronary artery disease. Twelve months after coronary sinus reducer implantation, 60.3% of the angiocad cohort, and 71.7% of the obstructive coronary artery disease cohort, had greater than or equal to one Canadian cardiovascular society class improvement. Twelve month mace rates were similar, 7.0% in the angiocad group, versus 8% in the obstructive coronary artery disease group. And both groups had significant improvements in the Seattle angina questionnaire, angina frequency, quality of life, and mean, Seattle angina questionnaire summary school. In conclusion, in the reducer one registry, patients with refractory angina and angiocad had significant improvements in their symptoms and quality of life, suggesting that coronary

3:08sinus reducer implantation may be an effect of therapy in these patients.