Spinal cord stimulation significantly decreases the need for acute hospital admission for chest pain in patients with refractory angina pectoris.
To assess the impact of spinal cord stimulation (SCS) on the need for acute admissions for chest pain in patients with refractory angina pectoris.
Design-Retrospective analysis of case records
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.