Implication of cognitive-behavioral stress management on anxiety, depression, and quality of life in acute myocardial infarction patients after percutaneous coronary intervention: a multicenter, randomized, controlled study

OBJECTIVE: Cognitive-behavioral stress management (CBSM) intervention enhances the psychological status and quality of life in patients with various diseases, such as cancer, human immunodeficiency virus infection, chronic fatigue syndrome, and multiple sclerosis. This multicenter, randomized, controlled study intended to explore the potential benefit of CBSM in ameliorating the anxiety, depression, and quality of life (QoL) in acute myocardial infarction (AMI) patients after percutaneous coronary intervention (PCI). METHODS: A total of 250 AMI patients who received PCI were randomly allocated to the CBSM (N = 125) and control care (CC) (N = 125) groups, and underwent weekly corresponding interventions for 12 weeks. The hospital anxiety and depression scale (HADS), EuroQol 5D (EQ-5D), and EuroQol visual analogue scale (EQ-VAS) scores were evaluated at baseline (M0), month (M)1, M3, and M6. Major adverse cardiovascular events (MACE) were recorded during follow-up. RESULTS: HADS-anxiety score at M1 (P = 0.036), M3 (P = 0.002), and M6 (P = 0.001), as well as anxiety rate at M6 (P = 0.026), was reduced in the CBSM group versus the CC group. HADS-depression score at M3 (P = 0.027) and M6 (P = 0.002), as well as depression rate at M6 (P = 0.013), was decreased in the CBSM group versus the CC group. EQ-5D score at M3 (P = 0.046) and M6 (P = 0.001) was reduced, while EQ-VAS score at M1 (P = 0.037), M3 (P = 0.010), and M6 (P = 0.003) was raised, in the CBSM group versus the CC group. However, accumulating MACE rate did not differ between the two groups (P = 0.360). CONCLUSION: CBSM ameliorates anxiety, depression, and QoL but does not affect MACE in AMI patients after PCI.