Table 1. Characteristics of Included Studies.
| Study | Country | Design | Selection criteria | Sample size (n) | Protocol and duration of EECP therapy | Technique of measuring myocardial perfusion | Data collection time points (pre- and post-EECP) |
|---|---|---|---|---|---|---|---|
| Arora 2007 | USA | Prospective, randomized, blinded | MUST-EECP inclusion and exclusion criteria* | 11 | One-hour sessions (once or twice daily, five days per week) for a total of 35 hours over four-seven weeks | Dynamic 13N positron emission tomography (PET) | Less than four weeks pre-EECP; less than two weeks post-EECP |
| Lawson 1992 | USA | Prospective, randomized, blinded | Included chronic, stable angina patients with exertional ischemia; excluded clinical CHF, aortic insufficiency, MI in the past three months, significant ventricular ectopic activity or atrial fibrillation, non-ischemic cardiomyopathy, severe occlusive peripheral vascular disease, recurrent deep vein thrombophlebitis, blood pressure >180/110 mm Hg, or bleeding diathesis | 18 | One-hour daily sessions for a total of 36 hours | Thallium-201 scan | Immediately before EECP; within one week post-EECP |
| Masuda 2001 | Japan | Prospective, observational, blinded | Included CAD patients (aged 21–81) with CCSC I-III; MUST-EECP exclusion criteria* | 11 | One-hour sessions (once or twice daily) for a total of 35 hours over a period of 18–35 days | Dynamic 13N positron emission tomography (PET) | Immediately before and after EECP |
| Michaels 2002 | USA | Prospective, randomized, blinded | Included CAD outpatients referred for catheterization; excluded severe aortic insufficiency, decompensated CHF, significant arrhythmia, systolic blood pressure >180 mm Hg, symptomatic PVD, abnormal Doppler Allen’s test of right upper extremity, or unsuitable lower extremity/coronary anatomy | 10 | EECP protocol not reported | 0.014” Doppler velocity guidewire positioned in the mid-to-distal portion of an unobstructed coronary artery under fluoroscopic guidance | Immediately before and during EECP |
| Michaels 2005 | USA | Prospective, randomized, blinded | Included CAD patients with CCSC II-IV or angina averaging at least twice weekly; MUST-EECP exclusion criteria* | 34 | One-hour sessions (once daily, five days per week) for a total of 35 hours over a seven-week period | Quantitative gated technetium Tc 99m sestamibi single photon emission computed tomography (SPECT) exercise perfusion imaging | Immediately before EECP; one month post-EECP |
| Tartaglia 2003 | USA | Prospective, randomized, blinded | Included CAD patients with CCSC class II or higher; excluded if unable to treadmill, MI within past six weeks, unstable angina, uncontrolled hypertension, severe valvular heart disease, or malignant ventricular arrhythmia | 25 | One-hour sessions (once or twice daily) for a total of 35 hours | Single-photon emission computed tomography (SPECT) | Immediately before and after EECP |
*Multicenter study of EECP (MUST-EECP) inclusion criteria: 23–82 years of age; Canadian Cardiovascular Society Class (CCSC) I, II, or III; coronary artery disease (CAD) evidenced by one of three measures; angiographic-proven disease of one major coronary artery, enzymatic and/or electrocardiographic (ECG) evidence of myocardial ischemia (MI), or positive nuclear exercise stress test for MI or ischemia.
MUST-EECP exclusion criteria: pregnant or of child-bearing potential and not using a contraceptive method; presenting with unstable angina, arrhythmias, or marked ECG abnormalities; MI or coronary artery bypass grafting (CABG) in the past three months; cardiac catheterization in the past two weeks; permanent pacemaker or implantable defibrillator; currently enrolled in a cardiac rehabilitation program; or any of the following: overt cardiac heart failure (CHF, left ventricular ejection fraction less than 30%); significant valvular disease; severe symptomatic peripheral vascular disease, history of varicosities, deep vein thrombosis/pulmonary embolism, phlebitis, and/or stasis ulcer; uncontrolled hypertension (greater than 180/110 mm Hg); bleeding diathesis; warfarin use with international normalized ratio of greater than 2.0; unable to treadmill test; or non-bypassed left main disease of greater than 50%.