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86 CAN SMOKING IMPROVE THE BENEFITS OF ENHANCED EXTERNAL COUNTERPULSATION BY STIMULATING ANGIOGENESIS IN AREAS OF ISCHEMIA?
  1. J. Tartaglia1,
  2. J. Stenerson1,
  3. E. Kennard1
  1. 1Port Chester, NY; University of Pittsburgh

Abstract

Objectives Smoking has been associated with increased angiogenesis in experimental animal models. We hypothesized that smokers undergoing enhanced external counterpulsation would have increased benefit due to recruitment of a larger number of coronary collaterals in regions of ischemia.

Methods We studied current smokers (C), non-smokers (N), and past smokers (P) enrolled in the International EECP registry who had one year follow-up. Angina symptoms and major cardiac events were examined at baseline, immediately after a course of EECP, and at one year.

Results C were younger (59 years vs. 67 years for P and 68 years for N, p<0.001) and more likely to be male (75% vs. 81% for P and 59% for N, p<0.001). They were more likely to have a prior MI (78% vs. 71% for P and 65% for N, p<0.001). Angina symptoms were similar, however, with 86% reporting CCS class 3 or 4 angina vs. 87% for P and 85% for N (p = NS). C were not able to augment as well as other patients (last peak ratio 0.93 vs. 1.05 for P and 1.15 for N, p<0.001 and only 76% completed the standard course treatment (vs. 83% for N and P, p<0.05). C showed similar reduction in angina status (73% down at least one CCS class, vs. 74% for P and 77% for N, p = NS), and there was no difference in the maintenance of this angina reduction at one year (74% vs. 78% vs. 76%, p = NS). Major cardiac events (death, MI, CABD, PCI) were identical in all three groups at 20% at one year.

Conclusion There is no evidence to support the hypothesis that smoking improves the benefit of enhanced external counterpulsation in angina patients.

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