Coronary Sinus Reducer implantation in refractory angina patients reduced nitrate use by 50%, improved CCS class by one grade in 50%, with no major cardiac events.
Does Coronary Sinus Reducer implantation improve symptoms and functional capacity in patients with refractory angina pectoris?
Coronary Sinus Reducer implantation demonstrated a favorable safety profile and led to reductions in nitrate consumption and angina class in a real-world cohort with refractory angina pectoris.
Absolute Event Rate: 0% vs 0%
Abstract Background Managing patients with refractory angina pectoris (RAP) remains challenging, as conventional therapies often provide insufficient relief. The Coronary Sinus Reducer (CSR) is a novel therapeutic device designed to alleviate symptoms in these patients. The CSR creates a focal narrowing in the coronary sinus, purportedly improving myocardial perfusion in ischemic territories. Objective To assess the procedural safety and clinical efficacy of the CSR device in a real-world cohort of patients with RAP treated at a single centre. Methods A retrospective analysis was conducted on 16 patients diagnosed with RAP who underwent treatment with CSR implantation between December 2020 and December 2024. Pre- and post-procedural evaluation was performed by stress myocardial perfusion imaging, nitrate consumption, the Canadian Cardiovascular Society (CCS) angina grading scale, six-minute walk test and a self-reported questionnaire for assessing health-related quality of life (HRQoL). Results CSR device was successfully implanted in 14 patients (men=13, mean age 68±7.7 years). One patient could not receive the device due to anatomical challenges, and another experienced device dislodgement during optimization of positioning which was removed uneventfully. No major adverse cardiac events were reported during following year. Hospital readmissions due to anginal symptom occurred in five patients between three and eight months after implantation. At follow up (mean±SD: 5±1.3 months), 50% used less nitrates and 50 % improved by one CCS class. No patient deteriorated in functional class. The walking distance increased on average by 18 m (SD 43) with a maximum gain of 81 m. The HRQoL scores improved in the subscales of bodily pain and social function. Conclusions In this case series, CSR treatment demonstrated a favorable safety profile with infrequent and manageable adverse events. The therapy led to a reduction in nitrate consumption and CCS class, alongside improvements in physical and social capacity for a substantial proportion of patients.
Wu et al. (Sat,) reported a other. Coronary Sinus Reducer implantation in refractory angina patients reduced nitrate use by 50%, improved CCS class by one grade in 50%, with no major cardiac events.