Safety, Efficacy, and Effectiveness of Coronary Sinus Reducer Implantation in Refractory Angina: A Meta-Analysis
Authors' conclusion
CSR implantation is safe and feasible and demonstrates promising antianginal efficacy in patients with RA.
Study context
- Population
- Patients with refractory angina3 randomized controlled trials (RCTs) (n = 180)
- Comparison
- Coronary sinus reducer (CSR) implantation vs placebo
- Outcome
- Placebo-controlled CCS class improvement
Methodological detailsrandom-effects models, preregistered
- Random-effects models
- Preregistered
Pooled result
As reported in the abstract
Placebo-controlled rate
26%
95% CI 11%–38%P < 0.001
≥1-class improvement
Placebo-controlled rate
17%
95% CI 2%–37%P = 0.02
≥2-class improvement
Further pooled results
| Outcome | Placebo-controlled change (seconds) (95% CI) | P value | |
|---|---|---|---|
| Treadmill exercise time change | 49.62 (1.84–97.40) | P = 0.04 | |
| −50050100Difference, seconds (linear scale) |
SAQ domains
- Insufficient placebo-controlled evidence of benefit
Single-arm studies and RCT intervention arms
- Statistically significant improvements across therapeutic outcomes
Safety
- Overall unweighted procedural success rate
- 98.3% (95% CI: 97.0%-99.1%)
- Safety outcomes summarized descriptively
Original publication
Safety, Efficacy, and Effectiveness of Coronary Sinus Reducer Implantation in Refractory Angina: A Meta-Analysis. JACC Cardiovasc Interv. Published 11 August 2025. doi:10.
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