Effect of extracorporeal cardiac shock wave therapy on prognosis for patients with coronary artery disease

Abstract

Objective To evaluate the effect of cardiac shock wave therapy on prognosis in patients with coronary artery disease. Methods Relevant randomized controlled trials(RCTs)were retrieved from PubMed, Google Scholar, Cochrane Library, and SinoMed databases.This meta-analysis was performed according to the PRISMA statement.Primary outcome was the rate of re-hospitalization. Results We identified 10 RCTs(422 patients)with a mean follow-up of(5.2±4.7)months(1-12 months). Overall, cardiac shock wave therapy could significantly lower the levels of CCS [weighted mean difference(WMD)=-0.64, 95%CI: -0.97 to -0.31, P<0.001], NYHA(WMD=-0.54, 95%CI: -0.86 to -0.53, P=0.001), increase the walk distance in 6 min(WMD=62.00 m, 95%CI: 41.64 to 82.37, P<0.001), Seattle angina questionnaire scores(WMD=12.79, 95%CI: 5.66 to 19.92, P<0.001)and left ventricular ejection fraction(WMD=5.11%, 95%CI: 0.18 to 10.03, P=0.04), decrease the left ventricular end-diastolic diameter(WMD=-3.99 mm, 95%CI: -6.38 to -1.60, P=0.001). Moreover, left ventricular perfusion scores(WMD=-8.52 mm, 95%CI: -11.98 to -5.07, P<0.001)and metabolism scores(WMD=-6.54 mm, 95%CI: -10.88 to -2.21, P=0.003)were both markedly decreased in those treated with cardiac shock wave therapy assessed by SPECT.Furthermore, rate of re-hospitalization was significantly decreased with cardiac shock wave therapy(RR=0.35, 95%CI: 0.23 to 0.54, P<0.001). Conclusions Cardiac shock wave therapy could improve the prognosis in patients with coronary artery disease, decrease the rate of re-hospitalization.However, more larger studies are warranted to confirm the long-term effect. Key words: Extracorporeal cardiac shock wave therapy; Coronary artery disease; Re-hospitalization; Prognosis; Meta-analysis