Season 3 - Ep.17: Coronary sinus reducer - Strategies to reach LDL cholesterol goals in high-risk patients

Jun 5, 2025

Carlos Aguiar, a cardiology expert known for summarizing key studies, joins the discussion to explore several cutting-edge topics. The coronary sinus reducer is highlighted as a promising solution for refractory angina, showcasing its innovative mechanisms and clinical trial results. Effective strategies for managing LDL cholesterol in high-risk patients are examined, stressing personalized treatment approaches. The insights into heart failure and atrial fibrillation reveal the importance of thorough diagnostic assessments and the impact of improved ejection fraction on outcomes.

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INSIGHT

Coronary Sinus Reducer Mechanism

The coronary sinus reducer redistributes blood flow from sub-epicardial to sub-endocardial areas to reduce angina.
Evidence from cardiac MRI shows increased myocardial perfusion correlating with symptom relief in refractory angina patients.

ADVICE

Patient Selection for Reducer

Use the coronary sinus reducer for patients with refractory angina who have no options for revascularization.
Thorough heart team evaluation ensures no further revascularization options before device implantation.

ADVICE

Implantation Procedure Tips

Perform coronary sinus reducer implantation via venous access with ultrasound guidance.
Ensure correct device placement using angiographic imaging and anchoring steps to prevent migration.

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This episode covers:

Cardiology this Week: A concise summary of recent studies

Coronary sinus reducer: promise in refractory angina

Best strategies to reach LDL cholesterol goals in high-risk patients

Snapshots

Host: Susanna Price

Guests: Carlos Aguiar, Rasha Al-Lamee, J. Wouter Jukema, Steffen Petersen

Want to watch that episode? Go to: https://esc365.escardio.org/event/1807

Want to watch that extended interview on LDL management? Go to: https://esc365.escardio.org/event/1807?resource=interview

Disclaimer

ESC TV Today is supported by Bristol Myers Squibb and Novartis.

This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.

This programme is intended for health care professionals only and is to be used for educational purposes.

The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices.

Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC.

Declarations of interests

Stephan Achenbach, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report.

Rasha Al-Lamee has declared to have potential conflicts of interest to report: speaker’s fees for Menarini pharmaceuticals, Abbott, Philips, Medtronic, Servier, Shockwave, Elixir. Advisory board: Janssen Pharmaceuticals, Abbott, Philips, Shockwave, CathWorks, Elixir.

Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede.

Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo.

J. Wouter Jukema has declared to have potential conflicts of interest to report: J. Wouter Jukema/his department has received research grants from and/or was speaker (CME accredited) meetings sponsored/supported by Abbott, Amarin, Amgen, Athera, Biotronik, Boston Scientific, Dalcor, Daiichi Sankyo, Edwards Lifesciences, GE Healthcare Johnson and Johnson, Lilly, Medtronic, Merck-Schering-Plough, Novartis, Novo Nordisk, Pfizer, Roche, Sanofi Aventis, Shockwave Medical, the Netherlands Heart Foundation, CardioVascular Research the Netherlands (CVON), the Netherlands Heart Institute and the European Community Framework KP7 Programme.

Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.

Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.