P6466Clinical efficacy of the external counterpulsation therapy in patients with stable coronary artery disease and obstructive sleep apnea

Abstract

Purpose: The goal of the study was to assess the efficacy of external counterpulsation (ECP) therapy in patients (pts.) with stable coronary artery disease (CAD) and severe obstructive sleep apnea (OSA). Methods: Open, non-controlled clinical study. Forty five (n=45) stable CAD with limiting angina (CCS, functional class II-III) and severe OSA (RDI>30 events/h) subjects (41 male and 4 female; mean age 65±13,4) received 35 hours ECPtreatment (250-300 mm Hg) course (5±2 one-hour ECP sessions per week; 5-7 weeks). All subjects refused of the CPAP-therapy. At baseline, immediately after ECP course, 6 months and 1 year after ECP course every subject was examined with exercise stress test, echocardiography, Holter monitoring (24h) and cardiorespiratory pulse arterial tonometry (PAT) monitoring during nighttime sleep. Results: 100% of pts. improved >1 angina class (CCS), 51% had no angina post treatment (p<0.01 baseline vs post-ECP). 80% of pts. had sustained improvement in angina class at 1-year follow-up. There was significant difference between baseline respiratory disturbance index (RDI) 37±5,4 events/h vs post- ECP RDI 19±4,6 events/h (p<0.01). 1-year survival rate was 100%. Conclusion: ECP therapy improves angina class and RDI in pts. with stable CAD and severe OSA.