Cognitive behavioral therapy intervention lowered risk for recurrent CVD

Gulliksson M. Arch Intern Med. 2011;171:134-140.

A cognitive behavioral therapy intervention program that focused on stress management plus traditional care decreased the recurrence of CVD and acute MI in patients discharged from a hospital after a coronary heart disease event when compared with traditional care alone.

In the study, 362 patients (aged <75 years) who had been discharged from a hospital within 12 months after a CHD event were randomly assigned to receive traditional care (n=170) or traditional care and an intervention featuring cognitive behavioral therapy (n=192). Researchers focused the cognitive behavioral therapy intervention on a stress management program that included 20 2-hour sessions during a 1-year period. Patients were followed for a mean of 94 months.

After adjustment for outcome-affecting variables, the intervention group had a significantly lower rate of fatal and nonfatal first recurrent CVD events (HR=0.59; 95% CI, 0.42-0.83) and recurrent acute MI (HR=0.55; 95% CI, 0.36-0.85) compared with the traditional care group. Although a reduction in all-cause mortality (HR=0.72; 95% CI, 0.40-1.30) in the intervention arm was reported, it was not statistically significant.

The findings suggest not only statistical but clinical significance, the researchers wrote, adding: “A dose-response relationship between attendance rate in the program and outcome was demonstrated. The benefit was equal for women and men. This demonstrates the potential efficacy of adding [cognitive behavioral therapy] to secondary preventive programs after [acute] MI for better patient adherence to treatment and better outcome.”

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