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A retrospective analysis was conducted of 79 consecutive patients who underwent enhanced external counterpulsation (EECP) at West Virginia University Hospitals during the period of November 1998 to September 2005 to determine its efficacy and safety in treating angina.A chart review and/or phone survey was performed to analyze pertinent clinical data (sublingual nitroglycerin use and angina class) pre and post EECP.A total of 60 (76%) patients who were referred for EECP successfully finished the 35 treatments.Seventy-five percent of the patient population improved at least one angina class after a full course of treatment.Therapy was discontinued due to adverse effects in 12 (15%) patients.Statistically significant improvements in angina class and reduction in anti-angina medications were observed in every co-morbid subgroup analyzed,including patients with peripheral vascular disease,diabetes,hyperlipidemia,hypertension,smoking,Post-MI,and LVEF < 40% (p<0.05,Wilcoxon Signed-Rank test).Overall,EECP was effective in improving angina as reflected in a substantial reduction in antiangina medications in 59 (75%) patients.