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Efficacy of coronary sinus Reducer in patients with refractory angina and diabetes mellitus

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Abstract

Coronary sinus Reducer (CSR) implantation is currently recommended to relieve angina in patients with refractory symptoms despite optimal medical therapy and maximally achievable revascularization. The impact of diabetes mellitus on outcome after CSR implantation is at present unknown. We aimed to explore the impact of CSR in refractory angina patients with diabetes mellitus. Data from consecutive patients undergoing CSR implantation at four different centres between 2014 and 2018 were included. Patients were divided according to the presence or absence of diabetes mellitus. Primary objective of this analysis was to evaluate the clinical response to CSR implantation defined as an improvement of ≥ 1 classes of the Canadian Cardiovascular Society (CCS) Classification. A total of 219 patients were included, 116 (53%) of whom had diabetes mellitus. The median age of the population was 69 years and 167 patients (76%) were male. There were no significant differences between groups of patients with and without diabetes mellitus with respect to CCS class at baseline (p value = 0.32) and at follow-up (p = 0.75). Over a median follow-up of 393 [224–1004] days, 84 (72%) of the patients with diabetes mellitus met the primary outcome, similarly to those without diabetes mellitus (p = 0.28). Fifty-three patients (24%) did not have an improvement in CCS class and no one experienced worsening of angina. CSR implantation was equally effective in improving angina symptoms among patients with refractory angina and diabetes mellitus compared to patients without diabetes mellitus.

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Author notes

  1. GiovanniM. Vescovo and Carlo Zivelonghi contributed equally to this work.

Authors and Affiliations

  1. Interventional Cardiology, Cardiovascular Center Middelheim Hospital, ZNA Middelheim, Lindendreef 1, 2020, Antwerp, Belgium

    Giovanni M. Vescovo, Carlo Zivelonghi, Pierfrancesco Agostoni & Stefan Verheye

  2. University Medical Center Utrecht, Utrecht, The Netherlands

    Mirthe Dekker, Max Silvis, Geert Leenders & Pieter Stella

  3. Department of Cardiology, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands

    Jan Peter van Kuijk & Leo Timmers

  4. Tel Aviv Medical Center, Tel Aviv University Sackler School of Medicine, Tel Aviv, Israel

    Shmuel Banai

Authors
  1. Giovanni M. Vescovo
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  2. Carlo Zivelonghi
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  3. Pierfrancesco Agostoni
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  4. Mirthe Dekker
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  5. Max Silvis
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  6. Geert Leenders
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  7. Jan Peter van Kuijk
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  8. Leo Timmers
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  9. Pieter Stella
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  10. Shmuel Banai
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  11. Stefan Verheye
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Contributions

GMV: conceptualization; data curation; formal analysis; interpretation of data; writing-original draft; final approval of the version. CZ: conceptualization; data curation; formal analysis; interpretation of data; writing-original draft; final approval of the version. PA: writing—review and editing; visualization; supervision. MD: data curation; writing—review and editing; validation; MS: data curation; writing—review and editing; validation; visualization; GL: data curation; validation; writing—review and editing. JPvK: resources; data curation; supervision; LT: resources; supervision; validation; writing—review and editing; PS: writing—review and editing; visualization; SB: data curation; writing—review and editing; visualization; SV: conceptualization; writing—review and editing; visualization; project administration.

Corresponding author

Correspondence to Stefan Verheye.

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Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Disclosure

S. Banai is Medical Director of Neovasc. S. Verheye and P. Agostoni are consultants for Neovasc Inc.

Ethical standards

All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Vescovo, G.M., Zivelonghi, C., Agostoni, P. et al. Efficacy of coronary sinus Reducer in patients with refractory angina and diabetes mellitus. Heart Vessels 37, 194–199 (2022). https://doi.org/10.1007/s00380-021-01909-9

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  • DOI: https://doi.org/10.1007/s00380-021-01909-9

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