To assess the impact of spinal cord stimulation (SCS) on the need for acute admissions for chest pain in patients with refractory angina pectoris.
Patients-19 consecutive patients implanted for SCS between 1987 and 1997.
All had three vessel coronary disease, and all were in New York Heart Association functional group III/IV.
Methods-Admission rates were calculated for three separate periods :
(1) from initial presentation up until last revascularisation ;
(2) from last revascularisation until SCS implantation ;
(3) from SCS implantation until the study date.
Post-revascularisation rates were then compared with post-SCS rates, without including admissions before revascularisation, as this would bias against revascularisation procedures.
Annual admission rate after revascularisation was 0.97/patient/year, compared with 0.27 after SCS (p=0.02).
Mean time in hospital/patient/year after revascularisation was 8.3 days v 2.5 days after SCS (p=0.04).
No unexplained new ECG changes were observed during follow up and patients presented with unstable angina and acute myocardial infarction in the usual way.
Conclusions-SCS is effective in preventing hospital admissions in patients with refractory angina, without masking serious ischaemic symptoms or leading to silent infarction.
Mots-clés Pascal : Angine poitrine, Réfractaire, Stimulation instrumentale, Moelle épinière, Stimulus électrique, Hospitalisation, Analyse coût efficacité, Economie santé, Traitement, Pronostic, Homme, Appareil circulatoire pathologie, Cardiopathie coronaire
Mots-clés Pascal anglais : Angina pectoris, Refractory, Instrumental stimulation, Spinal cord, Electrical stimulus, Hospitalization, Cost efficiency analysis, Health economy, Treatment, Prognosis, Human, Cardiovascular disease, Coronary heart disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0397930
Code Inist : 002B12A03. Création : 22/03/2000.