71 ENHANCED EXTERNAL COUNTERPULSATION IMPROVES MICROVASCULAR ANGINA IN CORONARY ARTERY DISEASE PATIENTS
Bibliographic record
Abstract
Background Enhanced external counterpulsation has been demonstrated to improve angina in patients with epicardial coronary disease (CAD) and in patients with microvascular angina without CAD. However, epicardial CAD and microvascular disease may coexist in the same patient and cause refractory angina. Enhanced external counterpulsation (EECP) may be of general utility in treating angina from either cause. Methods Coronary artery disease patients with refractory angina and a positive imaging stress test for regional ischemia in an area with normal perfusion by angiography were considered for inclusion. CAD included prior angioplasty, bypass surgery or catheterization demonstrating ≥ 50% stenosis of a major epicardial artery. Canadian Cardiovascular Society (CCS) angina class was assessed at baseline and after completion of a course of EECP (1 hour/day for a total of 35 hours). A follow-up imaging stress test was performed within 6 months of completing EECP. Statistical testing pre and post was performed by paired Student9s t test with significance at p<0.05. Results There were 15 patients (8 male, average age 67.6 ± 11.5 years), all of whom completed a 35-hour course of EECP. The CCS angina class improved from an average of 3.7 ± 0.5 to 1.8 ± 0.8 post therapy (p<0.05) with 14/15 improving ≥ 1 angina class. Post EECP imaging stress tests obtained in 11 patients demonstrated improvement/ resolution in ischemia in all the clinically improved patients (p<0.05). At an average follow-up of 4.9 ± 2.9 months, angina relief was maintained in all initially responding patients with an average angina class of 1.7 ± 0.9 (p<0.05). In intermediate term follow-up one patient developed worsening angina at 6.5 months and a second worsening angina at 8 months. Long term follow-up of up to 27.5 months has demonstrated persistent improvement in angina class in 12/15 patients. Conclusions EECP is an effective treatment for CAD patients with microvascular angina. Given its effectiveness in improving angina in patients with microvascular and epicardial CAD, EECP may be considered appropriate for any patient with refractory angina and demonstrable ischemia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".