Efficacy and Safety of Coronary Sinus Reducer for Refractory Angina: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Abstract Body (Do not enter title and authors here): Background. Refractory angina severely affects patients' quality of life around the world. Among the new treatment methods, the coronary sinus reducer (CSR) is one of the most thoroughly researched. Purpose. We aim to investigate the efficacy and safety of CSR for refractory angina. Methods. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) from PubMed, Web of Science, Scopus, Embase, and Cochrane searches until May 2024. Dichotomous data were pooled using risk ratio (RR), and continuous data were pooled using mean difference (MD), both with a 95% confidence interval (CI), using (R version 4.3). Results. With the inclusion of three RCTs, our cohort comprised a total of 180 patients. Compared to the control group, after six months, CSR was significantly associated with decreased mean change of Canadian cardiovascular society (CCS) class (MD: -0.54 with 95% CI [-0.80, -0.27], P< 0.01), an increased number of patients in the CCS class I (RR: 2.29 with 95% CI [1.14, 4.61], P= 0.02), a decreased number of patients in the CCS class III (RR: 0.53 with 95% CI [0.32, 0.87], P= 0.01), and increased exercise time (MD: 50.46 with 95% CI [9.47, 91.45], P= 0.02). However, there was no significant difference between CSR and the control group in CCS class II, class IV, across all Seattle Angina Questionnaire (SAQ) domains, the incidence of any serious adverse events (RR: 3.44 with 95% CI [0.82, 14.42], P= 0.09), stroke (RR: 2.13 with 95% CI [0.20, 22.88], P= 0.53), and all-cause mortality (RR: 1.06 with 95% CI [0.07, 16.59], P= 0.97). Conclusion. CSR has been shown to reduce angina severity by lowering CCS class scores and increasing exercise time. Large-scale RCTs are needed to confirm its effectiveness in patients with refractory angina.
Amin, Ahmed Mazen
( Mansoura university
, Mansoura
, Egypt
)
Khan, Ubaid
( University of Maryland, School of Medicine
, Baltimore
, Maryland
, United States
)
Katamesh, Basant
( Mayo Clinic
, Rochester
, Minnesota
, United States
)
Elbenawi, Hossam
( Mayo Clinic
, Rochester
, Minnesota
, United States
)
Ewis, Abdelrahman
( Mansoura university
, Mansoura
, Egypt
)
Iltaf, Arej
( khyber Girls Medical College
, Peshawar
, Kpk
, Pakistan
)
Author Disclosures:
Ahmed Mazen Amin:DO NOT have relevant financial relationships
| Ubaid Khan:DO NOT have relevant financial relationships
| Basant Katamesh:DO NOT have relevant financial relationships
| Yehya Khlidj:DO NOT have relevant financial relationships
| Hossam Elbenawi:DO NOT have relevant financial relationships
| Abdelrahman Ewis:DO NOT have relevant financial relationships
| Arej Iltaf:DO NOT have relevant financial relationships
