Abstract 11395: Enhanced External Counter Pulsation Improves Lipid Abnormalities in Patients With Chronic Ischemic Heart Disease

Abstract

Introduction: Enhanced external counter pulsation (EECP) is effective in improving anginal symptoms in patients with ischemic heart disease (IHD); however its effect on the lipid profile has not yet been reported. Hypothesis: Exercise like peripheral muscle training effect of EECP could improve lipid profile. Methods: Two hundred and twenty nine consecutive patients, age 61.2+/-9.5 years, 207 (90.3%) males, left ventricular ejection fraction 35.5+/-11.7%, referred for EECP therapy between 2013 and 2016 were included in the study. All patients had symptomatic IHD and were on anti-ischemic and statin therapy. Patients were subjected to 35 EECP sessions of one hour each. All patients were subjected to a thorough clinical evaluation and a 12 hour fasting lipid profile estimation at the baseline and after completion of 35 sessions of EECP therapy. Concomitant medical therapy, including statins, remained unaltered during the course of EECP. Results: Significant improvement was noted in functional class, 6 minute hall walk test and activity scale after EECP therapy. Lipid abnormalities were common in these patients at baseline with 104 (45.4%) subjects having low density lipoprotein cholesterol (LDLC) > 70 mg/dl, 128 (55.8%) having high density lipoprotein cholesterol (HDLC) <35mg/dl and 79 (34.5%) having triglycerides >140mg/dl. EECP resulted in significant improvement in lipid parameters in these patients- LDLC decreased by 18.5% (from 95.1+/-26.7 to 77.5+/-24.3 mg/dl, P value <0.0001), triglycerides decreased by 18.9% (from 198.3+/-76.4 to 160.8+/-56.6 mg/dl, , P value <0.0001) and HDLC increased by 14.2% (from 28.1+/-5.2 to 32.1+/-9.1 mg/dl, P value <0.0001). The subgroups with worse baseline lipid levels showed larger improvement- patients having baseline LDLC >100mg/dl showed 29.6% reduction in LDLC and those with HDLC <25mg/dl showed 41.3% increase in HDLC after EECP therapy. Conclusions: Patients with IHD having abnormal baseline lipid levels despite statin therapy show significant improvement in LDLC, triglyceride and HDLC levels after EECP therapy. This improvement is likely to be due to the exercise like peripheral muscle training effect of EECP and needs further evaluation.