One-year results of the randomized, controlled, short-term psychotherapy in acute myocardial infarction (STEP-IN-AMI) trial

Adriana Roncella, Christian Pristipino, Cinzia Cianfrocca, Silvia Scorza, Vincenzo Pasceri, Francesco Pelliccia, J. Denollet, S.S. Pedersen, Giulio Speciale

Research output: Contribution to journalArticleScientificpeer-review

Abstract

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.


Original languageEnglish
Pages (from-to)132-139
JournalInternational Journal of Cardiology
Volume170
Issue number2
DOIs
Publication statusPublished - 2013

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Incidence
Comorbidity
Infarction
Depression
5-nicotinooxymethyl-alpha-tocopherylnicotinate

Keywords

  • Aged
  • Angioplasty, Balloon, Coronary
  • Comorbidity
  • Existentialism
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Myocardial Infarction
  • Patient Readmission
  • Psychotherapy, Brief
  • Quality of Life
  • Treatment Outcome

Cite this

Roncella, Adriana ; Pristipino, Christian ; Cianfrocca, Cinzia ; Scorza, Silvia ; Pasceri, Vincenzo ; Pelliccia, Francesco ; Denollet, J. ; Pedersen, S.S. ; Speciale, Giulio. / One-year results of the randomized, controlled, short-term psychotherapy in acute myocardial infarction (STEP-IN-AMI) trial. In: International Journal of Cardiology. 2013 ; Vol. 170, No. 2. pp. 132-139.
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abstract = "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.",
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Roncella, A, Pristipino, C, Cianfrocca, C, Scorza, S, Pasceri, V, Pelliccia, F, Denollet, J, Pedersen, SS & Speciale, G 2013, 'One-year results of the randomized, controlled, short-term psychotherapy in acute myocardial infarction (STEP-IN-AMI) trial', International Journal of Cardiology, vol. 170, no. 2, pp. 132-139. https://doi.org/10.1016/j.ijcard.2013.08.094

One-year results of the randomized, controlled, short-term psychotherapy in acute myocardial infarction (STEP-IN-AMI) trial. / Roncella, Adriana; Pristipino, Christian; Cianfrocca, Cinzia; Scorza, Silvia; Pasceri, Vincenzo; Pelliccia, Francesco; Denollet, J.; Pedersen, S.S.; Speciale, Giulio.

In: International Journal of Cardiology, Vol. 170, No. 2, 2013, p. 132-139.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - One-year results of the randomized, controlled, short-term psychotherapy in acute myocardial infarction (STEP-IN-AMI) trial

AU - Roncella, Adriana

AU - Pristipino, Christian

AU - Cianfrocca, Cinzia

AU - Scorza, Silvia

AU - Pasceri, Vincenzo

AU - Pelliccia, Francesco

AU - Denollet, J.

AU - Pedersen, S.S.

AU - Speciale, Giulio

N1 - © 2013.

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N2 - 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.

AB - 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.

KW - Aged

KW - Angioplasty, Balloon, Coronary

KW - Comorbidity

KW - Existentialism

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Patient Readmission

KW - Psychotherapy, Brief

KW - Quality of Life

KW - Treatment Outcome

U2 - 10.1016/j.ijcard.2013.08.094

DO - 10.1016/j.ijcard.2013.08.094

M3 - Article

VL - 170

SP - 132

EP - 139

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 2

ER -