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Counterpulsation therapy linked to improved quality of life in angina patients

By Anthony J. Brown, MD

NEW YORK (Reuters Health) – In angina patients, short-term enhanced external counterpulsation (EECP) is associated with a significant improvement in health-related quality of life (HQOL) 12 months later, according to a recent report.

The procedure, which involves the application of compressive cuffs to the lower extremities, works by reducing the afterload on the heart and reducing the likelihood of angina.

Previously, Dr. Rohit R. Arora, from the New Jersey School of Medicine and Dentistry in Newark, and colleagues had shown that EECP lengthens the time to exercise-induced S-T segment-depression and reduces angina frequency.

In the current study, reported in the January issue of the Journal of Investigative Medicine, the researchers assessed the HQOL of 71 angina patients who participated in the original study, 12 months after undergoing therapy. The patients included 36 who underwent active counterpulsation therapy and 35 who underwent sham therapy. Patients in both groups received a total of 35 hours of therapy administered as one-hour daily sessions.

Patients in the active counterpulsation group experienced greater improvements in all HQOL scores than those in the sham group, immediately following treatment and 12 months later. For bodily pain, social functioning, and cardiac-specific QOL indices, the differences at 12 months were statistically significant at a p value < 0.05.

"The improvements in HQOL in the current study were even more impressive than the clinical improvements we observed in the original study," Dr. Arora told Reuters Health. "As a cardiologist, a patient's quality of life and ability to perform daily living activities is more important to me than improvements in clinical parameters," he said.

"The current findings also indicate that EECP's effects are sustained as demonstrated by the improved HQOL scores at 12-month follow-up," Dr. Arora emphasized.

"Outside of patients with really irregular rhythms and those with INRs greater than 3, most [cardiac patients] are eligible for EECP," Dr. Arora stated. He added that his group is currently investigating the use of EECP in patients with congestive heart failure.

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