Key result
Cognitive-behavioral therapy significantly reduced depression scores (SMD -0.99; 95% CI -1.44 to -0.54) and anxiety scores in patients with acute coronary syndrome.
Why the study?
The study aimed to evaluate the clinical efficacy and quality of life of cognitive-behavioral therapy in patients with acute coronary syndrome and comorbid anxiety and depression.
Does cognitive-behavioral therapy improve psychological symptoms, quality of life, and cardiovascular outcomes in patients with acute coronary syndrome and comorbid anxiety and depression?
Meta-Analysis (n=1,259)
Does cognitive-behavioral therapy improve psychological symptoms, quality of life, and cardiovascular outcomes in patients with acute coronary syndrome and comorbid anxiety and depression?
Answers are grounded in this paper and cite their sources.
Cognitive-behavioral therapy significantly reduces depression, anxiety, and cardiovascular adverse events in patients with acute coronary syndrome, though it does not clearly improve overall quality of life.
BACKGROUND: Our study aims to evaluate the clinical efficacy and quality of life of cognitive-behavioral therapy (CBT) for patients who have acute coronary syndrome (ACS) with anxiety and depression. METHODS: The databases of PubMed, Cochrane, and Web of science, as well as China journal full-text database, Wanfang database, and Weipu database, were systematically searched from the establishment of the database to February 29, 2020. The total effective rate of qualitative data was evaluated with a relative risk (RR) and 95% confidence interval (CI), and the quantitative data was evaluated with a standard mean difference (SMD) and 95% CI. Randomized controlled clinical trials of CBT for ACS were included. The RevMan5.3 and R3.5.1 software was used to analyze. RESULTS: A total of 11 papers, including 1,259 patients, were included, including 639 patients in the CBT group and 620 in the control group. One article reported the total effective rate after three months of treatment with an RR of 1.48 (95% CI: 1.07, 2.06). A total of 3 articles reported the incidence of cardiovascular adverse events using the fixed effects model (I2 =41%), and the incidence of cardiovascular adverse events in the CBT group was 0.39 times lower than that in the control group (95% CI: 0.2, 0.77). A total of 11 articles reported the score of depression using the random effects model (I2 =93%), and the score of depression in the CBT group was significantly lower than that in the control group, with an SMD of -0.99 (95% CI: -1.44, -0.54). The score of anxiety was reported in 8 pieces of literature, and the randomized effect model estimated that the score of anxiety in the CBT group was significantly lower than that in the control group, with an SMD of -1.47 (95% CI: -1.98, -0.96). There was significant heterogeneity in the quality of life score, but it was not found that the quality of life score in the CBT group was significantly higher than that in the control group. CONCLUSIONS: After CBT intervention, ACS patients with anxiety and depression can significantly reduce the incidence of cardiovascular adverse events and significantly reduce scores of depression and anxiety, but they have not been found to have an advantage in improving quality of life.
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Yu et al. (2020) conducted a meta-analysis in acute coronary syndrome with anxiety and depression (n=1,259). Cognitive-behavioral therapy (CBT) vs. Control group was evaluated on score of depression (SMD -0.99, 95% CI -1.44, -0.54). Cognitive-behavioral therapy significantly reduced depression scores (SMD -0.99; 95% CI -1.44 to -0.54) and anxiety scores in patients with acute coronary syndrome.
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