Coronary Sinus Reducer Improves Angina, Quality of Life, and Coronary Flow Reserve in Microvascular Dysfunction. Tryon D, Corban MT, Alkhouli M, Prasad A, Raphael CE, Rihal CS, Reeder GS, Lewis B, Albers D, Gulati R, Lerman A. JACC Cardiovasc Interv. 2024 Oct 23:S1936-8798(24)01202-0. PMID: 39520443
This Phase II trial evaluated the coronary sinus (CS) Reducer as a potential treatment for refractory angina in 30 ANOCA patients with CMD, defined by reduced coronary flow reserve (CFR ≤2.5) and/or an abnormal coronary blood flow (CBF) response to acetylcholine. At 120 days post-implantation, patients with endothelium-independent CMD showed a significant improvement in CFR (from 2.1 to 2.7, P = 0.0011), while those with endothelium-dependent CMD experienced improved CBF response (-11.0% to 11.5%, P = 0.042). Patients demonstrated substantial symptom improvement by Canadian Cardiovascular Society (CCS) angina class (median reduction from 4.0 to 2.0, P < 0.001) and quality of life, as measured by the Seattle Angina Questionnaire (P < 0.006 for all domains). These findings suggest the CS Reducer significantly enhances coronary microvascular function, alleviates angina, and improves quality of life, offering a promising therapy for CMD in ANOCA patients..