title: Enhanced External Counterpulsation for the relief of angina in patients with diabetes: safety, efficacy and 1-year clinical outcomes.
abstract: BACKGROUND
  Patients with diabetes are at greater risk for coronary events, yet they are less likely to benefit from revascularization than those without diabetes. Enhanced external counterpulsation has recently emerged as a treatment option for select patients with chronic stable angina.
  
  
  METHODS
  We examined baseline characteristics, angina response, and cardiac outcomes of patients with diabetes mellitus treated with Enhanced External Counterpulsation (EECP) for chronic stable angina. Data were collected from patients enrolled in the International EECP Patient Registry (IEPR) before and after a course of EECP, and at 1 year after completion of treatment.
  
  
  RESULTS
  Of 1532 IEPR patients studied, 43% had diabetes mellitus at baseline. Patients with diabetes were experiencing, on average, 11 episodes of angina per week. Most had been revascularized with prior percutaneous coronary intervention or coronary artery bypass graft surgery (86%) and most were considered unsuitable for either additional procedure (87%). Treatment was completed as prescribed in 79% of patients (mean, 32 hours). Immediately after EECP, 69% of patients with diabetes demonstrated a reduction in angina of > or =1 Canadian Cardiovascular Society angina class. After 1 year, maintenance of angina reduction was reported in 72% of patients with diabetes. Quality of life was significantly improved. Despite a high-risk profile among the diabetic group in this study, 1-year mortality was similar to coronary intervention registry populations.
  
  
  CONCLUSIONS
  This study suggests that in select patients with diabetes, EECP can be a safe, effective, well-tolerated treatment option for the relief of angina.
authors.affiliation: HeartGen Center, Indianapolis, Ind, USA.
authors.forename: Georgiann
authors.initials: G
authors.lastname: Linnemeier
authors.forename: Martin K
authors.initials: MK
authors.lastname: Rutter
authors.forename: Gregory
authors.initials: G
authors.lastname: Barsness
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Kennard
authors.forename: Richard W
authors.initials: RW
authors.lastname: Nesto
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000628:therapy*; D015908:Counterpulsation / Q000295:instrumentation / Q000379:methods*; D003925:Diabetic Angiopathies / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D005996:Nitroglycerin / Q000627:therapeutic use; D011446:Prospective Studies; D011788:Quality of Life; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin