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

21 Citations (Scopus)

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

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

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