To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: HFSA: Diabetic Patients with Angina Undergoing Enhanced External Counterpulsation Therapy: The Effect of Low Ejection Fraction URL: http://www.pslgroup.com/dg/21EEBE.htm Doctor's Guide September 27, 2002
By Gina Alexis Special to DG News BOCA RATON, FL -- September 27, 2002 -- Diabetic patients with a history of congestive heart failure and low ejection fraction derive the same benefit from external counterpulsation as patients with higher EF. External counterpulsation is a noninvasive device similar to the intra-aortic balloon pump that reduces anginal pain by increasing blood flow to the heart and decreasing cardiac workload. These findings were reported here September 24th at the 6th Annual Scientific meeting of the Heart Failure Society of America. Congestive heart failure is a common clinical problem in patients with diabetes. According to the Studies of Left Ventricular Dysfunction trials, diabetes increases the risk of heart failure and death in patients with low left ventricular ejection fraction (LVEF). The authors of the present study, led by Georgiann Linnemeier, analyzed demographic and clinical outcome data on all diabetic patients who had baseline recordings for ejection fraction and who were enrolled in the International External Counterpulsation Patient Registry maintained by the University of Pittsburgh Graduate School of Public Health. In this prospective observational study, patients were divided into two groups; 226 patients had an ejection fraction that was less than or equal to 35 percent, and 666 had an ejection fraction that was higher than 35 percent. Baseline characteristics, results following external counterpulsation treatment and one year follow-ups were all recorded. The researchers found that 76 percent of those with low ejection fraction were more likely to be men compared to 68 percent of those with a higher ejection fraction (p<0.05); myocardial infraction was seen in 85 percent and 63 percent, respectively (p<0.001); and congestive heart failure in 70 percent and 29 percent, respectively (p<0.001). Six percent of patients with low ejection fraction had unstable angina compared to two percent of those with high ejection fraction (p<0.05). Multivessel disease was seen in 87 percent and 78 percent of patients, respectively (p<0.01). Seventy-eight percent (78 percent) of patients with low ejection fraction were able to complete the treatment course compared to 83 percent; however, there was a significantly higher incidence of congestive heart failure, 7.5 percent compared to 2.6 percent (p<0.01), and deaths during the treatment period, 1.8 percent deaths compared to 0.0 percent (p<0.01). At one year follow-up there was a significantly higher death rate for low ejection fraction patients, 14 percent compared to five percent (p<0.001), and a higher incidence of congestive heart failure, 18 percent compared to nine percent (p<0.001); however, for those patients reporting angina at one year, there was no difference between the two groups and similar proportions maintained angina reduction, 69 percent compared to 72 percent with a high ejection fraction. The authors concluded that external counterpulsation provides an additional therapeutic option for diabetic patients with anginal pain and left ventricular dysfunction. These patients, who also had significant increased risk of heart failure and cardiac mortality, and were not candidates for other treatment options due to their high-risk profile, were able to reduce and manage angina at one-year follow-up. --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.