Type A behavioral counseling combined with cardiac counseling significantly reduced the 4.5-year cardiac recurrence rate to 12.9% compared to 21.2% with cardiac counseling alone (p<0.005).
RCT (n=1,013)
Randomly assigned
Does type A behavioral counseling combined with cardiac counseling reduce cardiac recurrences in post myocardial infarction patients?
Altering type A behavior through targeted counseling significantly reduces cardiac recurrences and mortality in post-myocardial infarction patients.
Absolute Event Rate: 12.9% vs 21.2%
p-value: p=<0.005
One thousand thirteen post myocardial infarction patients were observed for 4.5 years to determine whether their type A (coronary-prone) behavior could be altered and the effect such alteration might have on the subsequent cardiac morbidity and mortality rates of these individuals. Eight hundred sixty-two of these individuals were randomly assigned either to a control section of 270 participants who received group cardiac counseling or an experimental section of 592 participants who received both group cardiac counseling and type A behavioral counseling. The remaining 151 patients, serving as a "comparison group," did not receive group counseling of any kind. Using the "Intention-to-Treat" principle, we observed markedly reduced type A behavior at the end of 4.5 years in 35.1% of participants given cardiac and type A behavior counseling compared with 9.8% of participants given only cardiac counseling. The cumulative 4.5-year cardiac recurrence rate was 12.9% in the 592 participants in the experimental group that received type A counseling. This recurrence rate was significantly less (p less than 0.005) than either the recurrence rate (21.2%) observed in the 270 participants in the control group or the recurrence rate (28.2%) in those of the comparison group not receiving any special treatment. After the first year, a significant difference in number of cardiac deaths between the experimental and control participants was observed during the remaining 3.5 years of the study. Overall, the results of this study demonstrate for the first time, within a controlled experimental design, that altering type A behavior reduces cardiac morbidity and mortality in post infarction patients.
Friedman et al. (1986) conducted an RCT in Post myocardial infarction (n=1,013). Group cardiac counseling and type A behavioral counseling vs. Group cardiac counseling alone or no counseling was evaluated on Cumulative 4.5-year cardiac recurrence rate (p=<0.005). Type A behavioral counseling combined with cardiac counseling significantly reduced the 4.5-year cardiac recurrence rate to 12.9% compared to 21.2% with cardiac counseling alone (p<0.005).