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Long-term follow-up of patients with refractory angina treated with transcutaneous electrical nerve stimulation

Session Poster session 1

Speaker Jesus Alvarez-Garcia

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : J Alvarez-Garcia (Barcelona,ES), R Serra (Barcelona,ES), A Ferrero-Gregori (Barcelona,ES), J Cinca (Barcelona,ES), X Garcia-Moll (Barcelona,ES)

J. Alvarez-Garcia1 , R. Serra2 , A. Ferrero-Gregori1 , J. Cinca1 , X. Garcia-Moll1 , 1Hospital de la Santa Creu i Sant Pau, IIb-Sant Pau, CIBERCV, Universitat A, Cardiology - Barcelona - Spain , 2Hospital de la Santa Creu i Sant Pau, Anestesiology - Barcelona - Spain ,

European Heart Journal ( 2017 ) 38 ( Supplement ), 192

Background: Transcutaneous electrical nerve stimulation (TENS) improves quality of life of patients with refractory angina (RA). However, the natural history and predictors of adverse outcome in series with long follow-up are not well-known.

Purpose: To describe the clinical profile and long-term prognosis of patients with refractory angina with TENS.

Methods: A cohort of 159 RA patients with TENS was prospectively followed for a median of 4.4 years. Baseline characteristics were compared with the last visit at follow-up at a RA clinic. Mixed-effects logistic regressions were used to identify independent predictors of mortality.

Results: Clinical data are summarized in table. Mean age was 70.1 years and 59.7% were male. The mean number of vessels disease was 2.6, and the mean evolution of ischemic heart disease was 13.1 years. As compared with baseline, there was a significant reduction in the number of chest pain episodes per week (10.1 vs. 3.1, p<0.001) and consumption of sublingual nitrates per week ((9.5 vs. 2.6, p<0.001). 31 patients died (19.5%) and 39 (24.5%) were readmitted for acute coronary syndrome. The independent predictors of all-cause mortality were age (OR 1.08; CI 95%: 1.03–1.13), peripheral artery disease (OR 3.16; CI 95%: 1.29–7.74), and treatment with statins (OR 0.43; CI 95%: 0.20–0.96).

Conclusion: Beneficial effects of TENS on reducing angina symptoms in patients with refractory angina persisted after a long-term follow-up.

Table 1
BaselineFollow-up visitp
Smokers, n (%)142 (89.3)14 (11.0)ns
Hypertension, n (%)94 (59.1)76 (59.7)ns
Dyslipidemia, n (%)90 (56.6)73 (57.0)ns
Diabetes mellitus, n (%)65 (40.9)52 (41.0)ns
Previous MI, n (%)79 (65.3)84 (66.0)ns
Previous PTCA, n (%)40 (34.5)55 (42.9)ns
Previous CABG, n (%)63 (52.5)66 (52.6)ns
Beta-blockers, %60.4%69.2%<0.001
Calcium blockers, %49.1%59.1%<0.001
Long acting nitrates, %54.7%74.8%<0.001
Antiplatelet therapy, %79.7%84.9%<0.001
Statins, %32.1%66%<0.00

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