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Cardiovasc Ultrasound. 2017 Apr 12;15(1):11. doi: 10.1186/s12947-017-0102-y.

Cardiac shock-wave therapy in the treatment of coronary artery disease: systematic review and meta-analysis.

Author information

1
Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. gburneikaite@gmail.com.
2
Centre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania. gburneikaite@gmail.com.
3
, Room No A311, Santariskiu str. 2, 08661, Vilnius, Lithuania. gburneikaite@gmail.com.
4
Moscow State University of Medicine and Dentistry, Moscow, Russia.
5
Yale- New Haven Health Bridgeport Hospital, Connecticut, United States of America.
6
Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania. jelena.celutkiene@santa.lt.
7
Centre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania. jelena.celutkiene@santa.lt.
8
Clinic of Cardiac and Vascular Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
9
Centre of Cardiology and Angiology, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
10
Centre of Innovative Medicine, Vilnius, Lithuania.
11
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, United States of America.

Abstract

AIM:

To systematically review currently available cardiac shock-wave therapy (CSWT) studies in humans and perform meta-analysis regarding anti-anginal efficacy of CSWT.

METHODS:

The Cochrane Controlled Trials Register, Medline, Medscape, Research Gate, Science Direct, and Web of Science databases were explored. In total 39 studies evaluating the efficacy of CSWT in patients with stable angina were identified including single arm, non- and randomized trials. Information on study design, subject's characteristics, clinical data and endpoints were obtained. Assessment of publication risk of bias was performed and heterogeneity across the studies was calculated by using random effects model.

RESULTS:

Totally, 1189 patients were included in 39 reviewed studies, with 1006 patients treated with CSWT. The largest patient sample of single arm study consisted of 111 patients. All selected studies demonstrated significant improvement in subjective measures of angina symptoms and/or quality of life, in the majority of studies left ventricular function and myocardial perfusion improved. In 12 controlled studies with 483 patients included (183 controls) angina class, Seattle Angina Questionnaire (SAQ) score, nitrates consumption were significantly improved after the treatment. In 593 participants across 22 studies the exercise capacity was significantly improved after CSWT, as compared with the baseline values (in meta-analysis standardized mean difference SMD = -0.74; 95% CI, -0.97 to -0.5; p < 0.001).

CONCLUSIONS:

Systematic review of CSWT studies in stable coronary artery disease (CAD) demonstrated consistent improvement of clinical variables. Meta-analysis showed a moderate improvement of exercise capacity. Overall, CSWT is a promising non-invasive option for patients with end-stage CAD, but evidence is limited to small sample single-center studies. Multi-center adequately powered randomised double blind studies are warranted.

KEYWORDS:

Cardiac shock wave therapy; coronary artery disease; refractory angina; stable angina pectoris

PMID:
28403861
PMCID:
PMC5389112
DOI:
10.1186/s12947-017-0102-y
[Indexed for MEDLINE]
Free PMC Article

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