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Title
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One-year results of the randomized, controlled, short-term psychotherapy in acute myocardial infarction (STEP-IN-AMI) trial
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Author
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Abstract
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| 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 rehospitalizations, 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 (c) 2013 Elsevier Ireland Ltd. All rights reserved. |
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Language
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English
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Source (journal)
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International journal of cardiology. - Amsterdam, 1981, currens
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Publication
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Amsterdam
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2013
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ISSN
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0167-5273
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DOI
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10.1016/J.IJCARD.2013.08.094
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Volume/pages
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170
:2
(2013)
, p. 132-139
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ISI
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000327889200018
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Full text (Publisher's DOI)
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Full text (publisher's version - intranet only)
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