Abstract
Byline: Azka Latif, Creighton Univ Sch of medicine, omaha, NE; Muhammad J Ahsan, Dept of Internal Medicine, Creighton Univ Sch of medicine, Omaha, NE; Mohsin Mirza, Creighton Univ Sch of medicine, omaha, NE; Abhishek Thandra, Dept of Internal Medicine, Div of Cardiology, Creighton Univ Sch of medicine, omaha, NE; vikas kapoor, Dept of Internal Medicine, Creighton Univ Sch of medicine, omaha, NE; Muhammad Zoraiz Ahsan, Dept of Internal Medicine, Pakistan Med and Dental Association, omaha, NE; Aiman Smer, Dept of Internal Medicine, Div of Cardiology, Creighton Univ Sch of medicine, omaha, NE Introduction: Cardiac shock wave therapy (CSWT) using low-intensity shock waves is a non-invasive therapeutic option in the management of chronic refractory angina. This meta-analysis aimed to review the available studies on CSWT and observe its anti-anginal efficacy. Methods: PubMed, Embase, Cochrane, ClinicalTrials.gov, and Google Scholar were searched for studies evaluating the efficacy of CSWT in patients with refractory angina from January 1, 2000, until March, 2021. The primary outcome was the assessment of left ventricular ejection fraction (LVEF) before and after CWST. The secondary outcome was myocardial perfusion before and after CSWT. The analysis was performed using a random-effects-model using the Mantel-Haenszel method and results presented as 95% confidence interval using STATA version 15.1 software. Results: Twenty-four studies (20 observational and 4 Controlled Trails) with a total of 503 patients were included in the meta-analysis. The mean age was 64.92 Ø 9 years and 25% were females. In patients undergoing CSWT, left ventricular ejection fraction improved significantly in patients undergoing CSWT (SMD: 0.31, 95% CI: 0.14 to 0.48, P = 0.0003, I2 = 41%, Figure 1B). Likewise, myocardial perfusion improved significantly in patients undergoing CSWT (SMD: 0.74, 95% CI: 0.39 to 1.090, P = <0.05, I2 = 84%, Figure 1A). Conclusions: Based on our results, CSWT is a promising noninvasive modality for the management of refractory angina in patients with stable coronary artery disease and on optimal medical therapy.