THE EFFECT OF A PSYCHOLOGICAL INTERVENTION PROGRAM ON THE RISK OF A NEW CORONARY EVENT AFTER ANGIOPLASTY A FEASIBILITY STUDY

Restenosis after successful percutaneous coronary angioplasty (PTCA) i s a major problem because it occurs in 25% to 35% of all patients. Bec ause psychological factors, especially anger and vital exhaustion, hav e been found to increase the risk of new cardiac events after PTCA, a behavioral intervention might contribute to the reduction of the risk of restenosis. To investigate the operational and methodological aspec ts of a behavioral intervention, and to estimate the effect size of th e risk reduction, we did a feasibility study of angioplasty patients w ho remained exhausted after PTCA. Breathing therapy was used as the ma in method for intervention. Thirty patients who participated in the in tervention program and 65 controls were followed during an average per iod of 16 and 18 months, respectively. It was observed that the interv ention resulted in a significant decrease of the mean exhaustion score s and reduced the risk of a new coronary event (cardiac death, coronar y artery bypass grafting, myocardial infarction, rePTCA, restenosis) b y 50% ((X)=2.19; p=0.13). These results indicate that a clinical trial to test the hypothesis that a reduction of vital exhaustion and hosti lity reduces the risk of a new cardiac event after PTCA, is feasible a nd merits the efforts required. (C) 1997 Elsevier Science Inc.