Conclusions We found that psychological intervention  improved psychological symptoms and reduced cardiac mortality for people with CHD .
However , there remains considerable uncertainty regarding the magnitude of these effects and the specific techniques most likely to benefit people with different presentations of CHD
Background Although psychological interventions are recommended for the management of coronary heart disease ( CHD ) , there remains considerable uncertainty regarding their effectiveness .
Short-TErm Psychotherapy IN Acute Myocardial Infarction (STEP-IN-AMI) Trial: Final Results.
PURPOSE The purpose of this research was to assess whether short-term psychotherapy enhances long-term clinical outcomes in patients with a recent acute myocardial infa rct ion ( AMI ) . METHODS Patients ≤70 years old were r and omized within 1 week of their AMI to short-term ontopsychological psychotherapy plus routine medical therapy vs routine medical therapy only . The primary composite outcome was defined as the combined incidence of new cardiovascular events ( re-infa rct ion , death , stroke , revascularization , life-threatening ventricular arrhythmias , and the recurrence of clinical ly significant angina ) and clinical ly significant new comorbidities . Secondary outcome measures were : rates for individual components of the primary composite outcome ; the rate of re-hospitalization for cardiovascular problems ; and New York Heart Association functional class . RESULTS Ninety-four patients were analyzed , translating into 425 patient-years . The 2 treatment groups were similar across baseline characteristics . At 5-year follow-up , psychotherapy patients had a lower incidence of primary outcome , relative to controls ( 77/223 vs 98/202 patient-years , respectively ; P = .035 ; absolute risk reduction = 19 % , number needed to treat = 8) ; this benefit was attributable to the lower incidence of new comorbidities and clinical ly significant angina in the psychotherapy group . Gains in the primary outcome , relative to controls , among psychotherapy patients occurred in the first year and subsequently remained stable over the following 4 years . CONCLUSIONS Adding short-term ontopsychological psychotherapy to routine secondary prevention of myocardial infa rct ion improves clinical outcomes overall up to 5 years post AMI . Study ing time trends may aid in better targeting of psychological interventions during follow-up . Larger studies remain necessary to confirm these results . TRIAL REGISTRATION www . Clinical Trial.gov NCT00769366
Conclusions We found that psychological intervention  improved psychological symptoms and reduced cardiac mortality for people with CHD .
However , there remains considerable uncertainty regarding the magnitude of these effects and the specific techniques most likely to benefit people with different presentations of CHD
Background Although psychological interventions are recommended for the management of coronary heart disease ( CHD ) , there remains considerable uncertainty regarding their effectiveness .