Abstract
Enhanced external counterpulsation (EECP) is believed to be a non-invasive treatment for coronary artery disease and angina. The aim of this study was to determine the safety and effectiveness of EECP in refractory angina patients through a systematic reviews and meta-analysis. We conducted a comprehensive search of the literature published on PubMed, Cochrane library, Scopus, ScienceDirect, Trip Database and Google Scholar databases using appropriate keywords and specific strategy with no time limit. Having selected and screened the studies based on the defined inclusion and exclusion criteria and evaluating their quality based on the Cochrane checklist. For the meta-analysis,the Mantel-Haenszel method or the generic Inverse Variance was used. Analyses were done with Review Manager 5.2 software. A number of 299 studies were initially reviewed and finally, seventeen studies were included in the meta-analysis based on the inclusion and exclusion criteria. Also, thirteen outcomes were analyzed and the results of meta-analysis in twelve outcomes including (Systolic Blood Pressure (7 studies), Diastolic Blood Pressure (7 studies), Pulse Pressure (4 studies), Mean Arterial Pressures (4 studies), Heart Rate (6 studies), Angina episodes (7 studies), Walking distance (2 studies),Canadian Cardiovascular Society classification (6 studies), Flow-Mediated Dilation (3 studies), Daily Nitrate Usage (4 studies), Exercise Treadmill Test-Time (2 studies), ST-segment depression (2 studies)demonstrated a significant clinical advantage in the EECP treatment effectiveness in patients with angina. No significant difference was observed regarding EECP usefulness (P = 0.18) in the outcome of brachial artery diameter (2 studies). Based on the meta-analysis, the results indicate the safety and effectiveness of EECP in patients with angina pectoris and indicate the usefulness of this treatment in these patients. In general, the authors believe that the general conclusion in this regard requires some studies with a large sample size and a control group assignment.
Highlights
The cardiovascular disease epidemic has plagued most countries worldwide
Search Strategy Keywords including (EECP, Enhanced External Counterpulsation, External counter pulsation, Angina) in PubMed, Cochrane library, Scopus, Science Direct, Trip databases were applied to garner research studies that reported on the safety and effectiveness of external counterpulsation (EECP) technology with no time limit until May 2021
Eligibility criteria Population: Angina patients; Intervention: Enhanced External Counterpulsation (EECP); Outcome: Clinical efficacy, functional consequences, side effects and safety; Type of studies: Trial and observational studies Exclusion criteria were that; 1) Studies published in languages other than English or Persian; 2) Studies whose statistical data were incomplete or not reported at all; 3) Studies that have not evaluated the intended outcomes; 4) Studies without explicit methodology or results; 5) Studies whose population was arrhythmias leading to dysfunction, active thrombophlebitis, aortic aneurysms, significant valvular diseases, or pregnant women
Summary
The cardiovascular disease epidemic has plagued most countries worldwide. many cardiovascular diseases can be treated, it is still the leading cause of death in men and women throughout the world.[1]According to the World Health Organization (WHO), 17.9 million people died of cardiovascular disease in 2019, accounting for 32% of all deaths per year. The cardiovascular disease epidemic has plagued most countries worldwide. Many cardiovascular diseases can be treated, it is still the leading cause of death in men and women throughout the world.[1]. According to the World Health Organization (WHO), 17.9 million people died of cardiovascular disease in 2019, accounting for 32% of all deaths per year. Cardiovascular mortality is predicted to account for more than 23.6 million per year by 2030.3 The total cost incurred due to cardiovascular disease is reported to be $ 177.5 billion annually.[4]. Cardiovascular diseases can be prevented through addressing behavioral risk factors such as smoking, unhealthy diet, obesity, physical inactivity and persistent alcohol use. People with cardiovascular disease or people at high cardiovascular risk need to be diagnosed and managed early through counseling and medication, if required.[2]. Rayegani et al known as angina pectoris, is chest pain, usually caused by blockage or spasm of the arteries that carry blood to the heart muscle.[5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
