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 .
Psychosocial Treatment Within Sex by Ethnicity Subgroups in the Enhancing Recovery in Coronary Heart Disease Clinical Trial
Objective : Intervening in depression and /or low perceived social support within 28 days after myocardial infa rct ion ( MI ) in the Enhancing Recovery in Coronary Heart Disease ( ENRICHD ) clinical trial did not increase event-free survival . The purpose of the present investigation was to conduct post hoc analyses on sex and ethnic minority subgroups to assess whether any treatment subgroup is at reduced or increased risk of greater morbidity/mortality . Methods : The 2481 patients with MI ( 973 white men , 424 minority men , 674 white women , 410 minority women ) who had major or minor depression and /or low perceived social support were r and omly allocated to usual medical care or cognitive behavior therapy .  Total mortality or recurrent nonfatal MI ( ENRICHD primary endpoint ) and cardiac mortality or recurrent nonfatal MI ( secondary endpoint ) were analyzed as composite endpoints by group for time to first event using Cox proportional hazards regression . Results : There was a trend in the direction of treatment efficacy for white men for the primary endpoint ( hazard ratio [ HR ] , 0.80 ; 95 % confidence interval , 0.61–1.05 ; p = .10 ) and a significant ( p < .006 , Bonferroni corrected ) effect for the secondary endpoint ( HR , 0.63 ; 95 % CI , 0.46–0.87 ; p = .004 ) . In contrast , the HRs for each of the other three subgroups were nonsignificant . The magnitude of differences in treatment effects between white men and the other subgroups remained significant for the secondary endpoint ( p = .04 ) after adjustment for age , education , living alone , antidepressant use , comorbidity score , cardiac catheterization , ejection fraction , history of hypertension , and major depression . Conclusions : White men , but not other subgroups , may have benefited from the ENRICHD intervention , suggesting that future studies need to attend to issues of treatment design and delivery that may have prevented benefit among sex and ethnic subgroups other than white men
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 .