Of 196 patients, 46 patients withdrew from the study during the study period. The reasons for dropping out are given in Fig. 1. Their mean age was 63.8 years with range from 26 to 82 years (SD = 9.6). As shown in Table 3, no significant differences in demographic and clinical characteristics, and baseline ESC (p > 0.05) were found among the C, PE and ESMI groups at baseline.