BACKGROUND: Previous studies on cognitive and interpersonal interventions have yielded inconsistent results in ischemic heart disease patients. METHODS:101 patients aged ≤ 70 years, and enrolled one week after complete revascularization with urgent/emergent angioplasty for an AMI, were randomized to standard cardiological therapy plus short-term humanistic-existential psychotherapy (STP) versus standard cardiological therapy only. Primary composite end point was: one-year incidence of new cardiological events (re-infarction, death, stroke, revascularization, life-threatening ventricular arrhythmias, and the recurrence of typical and clinically significant angina) and of clinically significant new comorbidities. Secondary end points were: rates for individual components of the primary outcome, incidence of re-hospitalizations for cardiological problems, New York Heart Association class, and psychometric test scores at follow-up. RESULTS:94 patients were analyzed at one year. The two treatment groups were similar across all baseline characteristics. At follow-up, STP patients had had a lower incidence of the primary endpoint, relative to controls (21/49 vs. 35/45 patients; p=0.0006, respectively; NNT=3); this benefit was attributable to the lower incidence of recurrent angina and of new comorbidities in the STP group (14/49 vs. 22/45 patients, p=0.04, NNT=5; and 5/49 vs. 25/45, p<0.0001, NNT=3, respectively). Patients undergoing STP also had statistically fewer re-hospitalizations, a better NYHA class, higher quality of life, and lower depression scores. CONCLUSION: Adding STP to cardiological therapy improves cardiological symptoms, quality of life, and psychological and medical outcomes one year post AMI, while reducing the need for re-hospitalizations. Larger studies remain necessary to confirm the generalizability of these results. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov: NCT00769366.
RCT Entities:
BACKGROUND: Previous studies on cognitive and interpersonal interventions have yielded inconsistent results in ischemic heart diseasepatients. METHODS: 101 patients aged ≤ 70 years, and enrolled one week after complete revascularization with urgent/emergent angioplasty for an AMI, were randomized to standard cardiological therapy plus short-term humanistic-existential psychotherapy (STP) versus standard cardiological therapy only. Primary composite end point was: one-year incidence of new cardiological events (re-infarction, death, stroke, revascularization, life-threatening ventricular arrhythmias, and the recurrence of typical and clinically significant angina) and of clinically significant new comorbidities. Secondary end points were: rates for individual components of the primary outcome, incidence of re-hospitalizations for cardiological problems, New York Heart Association class, and psychometric test scores at follow-up. RESULTS: 94 patients were analyzed at one year. The two treatment groups were similar across all baseline characteristics. At follow-up, STPpatients had had a lower incidence of the primary endpoint, relative to controls (21/49 vs. 35/45 patients; p=0.0006, respectively; NNT=3); this benefit was attributable to the lower incidence of recurrent angina and of new comorbidities in the STP group (14/49 vs. 22/45 patients, p=0.04, NNT=5; and 5/49 vs. 25/45, p<0.0001, NNT=3, respectively). Patients undergoing STP also had statistically fewer re-hospitalizations, a better NYHA class, higher quality of life, and lower depression scores. CONCLUSION: Adding STP to cardiological therapy improves cardiological symptoms, quality of life, and psychological and medical outcomes one year post AMI, while reducing the need for re-hospitalizations. Larger studies remain necessary to confirm the generalizability of these results. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov: NCT00769366.
Authors: Suzanne H Richards; Lindsey Anderson; Caroline E Jenkinson; Ben Whalley; Karen Rees; Philippa Davies; Paul Bennett; Zulian Liu; Robert West; David R Thompson; Rod S Taylor Journal: Cochrane Database Syst Rev Date: 2017-04-28
Authors: Nader N Kabboul; George Tomlinson; Troy A Francis; Sherry L Grace; Gabriela Chaves; Valeria Rac; Tamara Daou-Kabboul; Joanna M Bielecki; David A Alter; Murray Krahn Journal: J Clin Med Date: 2018-12-04 Impact factor: 4.241
Authors: Sabina Alexandra Cojocariu; Alexandra Maștaleru; Radu Andy Sascău; Cristian Stătescu; Florin Mitu; Elena Cojocaru; Laura Mihaela Trandafir; Maria-Magdalena Leon-Constantin Journal: J Pers Med Date: 2021-05-21