2. “External counter pulsation is another promising alternative treatment of refractory angina. Data suggest that ECP       reduce the frequency of angina and the use of nitroglycerin and improves exercise tolerance and quality of life. In a       randomized, double-blind, sham – controlled study of ECP for patients with chronic stable angina, counter pulsation       was associated with an increase in time to ST segment depression during exercise testing and a reduction in       angina. It also reduced the extent of ischemia detected with myocardial perfusion imaging.”
      -----------------------------------------------Braunwald’s text book of Cardiovascular Medicine: Edition 7th, Page 1308

3. “Million of cases treated with ECP, illustrates the capacity of EECP into revascularization the heart and control       symptoms in patients who have not benefited from balloon angioplasty or bypass surgery. The author describe a 58       year old man who required two separate bypass surgery, six rounds of angioplasty involving over 20 narrowing and       multiple heart catheterization, all within a 26 month time period. Finally, one artery closed off completely and further       angioplasty was not possible. The patient was then begun on EECP and experienced a “dramatic” reduction in       symptoms within 3 weeks. Upon completion of a 120 hour course, this patient’s stress nuclear scan normalized and       angina fully resolved. Three years out from EECP he remains asymptomatic.”
      --------------------------------Enhanced External Counter pulsation as an Adjunct to Revascularization in       Unstable Angina Lawson WE, Hui JCK, Oster ZH, et al. Clinical Cardiology 1997; 178-180.

4. STONY BROOK TRIALS:
    Open label studies on the safely and effectiveness of EECP in patient with chronic stable angina pectoris were     conducted at the State University of New York at Stony Brook, beginning in1989 and was reported by Lawson el at in     American Journal of Cardiology in 1992. All of those patients had incapacitating symptoms, refractory to medical     therapy and external myocardial ischemia documented by thallium-201 perfusion imaging. All patients in this study     showed a substantial improvement in symptoms with most reporting a complete absence of angina during normal     activity. In addition, the majority of patients in this study showed a reduction in myocardial ischemia, with two-thirds     demonstrating a complete absence of reversible defects. These results were accompanied by a significant increase     in the mean duration of exercise during maximal stress testing of between 95 and 112 seconds.

5. MUST EECP STUDY:
    In 1995, a large randomized, controlled and double blinded multicentre trial on the efficiency of EECP in patients with     chronic stable angina (MUST-EECP) was undertaken at seven leading university hospitals in the United States. The     MUST EECP trial results were published in the Journal of the American Cardiology in June 1999”. A total of 139     patients were enrolled in this study and randomly assigned to active or sham group. Those assigned to the active     group were given full pressure. Those randomized to the sham group were treated with low pressure. Patients     enrolled in study ranged from 18-21 years of age, were classified as having DDS’ Class 1, 2, or 3 angina and had     documented coronary artery disease, including a positive exercise stress test within 4 weeks of beginning EECP     therapy.

    Patient in the active EECP group demonstrated significantly increased time to exercise induced ST segment     depression when compared to sham and baseline. Those in the active EECP group reported a significant decrease in     the frequency of angina counts. Exercise duration increased significantly in both group but was greater in the active     EP group.

6. INTERNATIONAL EECP PATIENT REGISTRY (IEPR):
    In 1988, the International EECP Patient registry (IEPR) was established to document patient and characteristic for     those undergoing EECP therapy, the safely and efficacy of EECP therapy and the therapy’s long term outcomes in the     broader population. More than 6000 patients had been enrolled in the registry. An analysis of long-term outcomes     suggests that the clinical benefits achieved are sustained upto three years following an initial course of treatment.

7. OTHER STUDIES:
    A study published in 2001 in the journal of American Collage of Cardiology by Urano at al. of Kurume University in     Japan confirmed once more the benefits of EECP reported in the literature to date, a decline in anginal frequency, an     increase in exercise capacity and a decrease in exercise induced in signs of myocardial ischemia. Additionally this     study provides clear evidence that EECP improves diastolic filling in patients with coronary artery disease. The study     showed that both the peak filling rate and the time to peak filling improved significantly. These indicators of improved     cardiac function were also reflected in decreased levels of brain is secreted mainly by the left ventricle in response to     stress and is a sensitive measure of cardiac function.

    For more insight into ECP, refer to internet. Type “EECP” in any of the search engine to get an access to     more then 1 lac clinical sites.