Brief Mindfulness-Based Cognitive Therapy in Women With Myocardial Infarction: Results of a Multicenter Randomized Controlled Trial.
Tanya M Spruill, Chorong Park, Jolaade Kalinowski, Milla E Arabadjian, Yuhe Xia, Amanda J Shallcross, Pallavi Visvanathan, Nathaniel R Smilowitz, Anaïs Hausvater, Sripal Bangalore, Hua Zhong, Ki Park, Puja K Mehta, Dwithiya K Thomas, Jeffrey Trost, Kevin R Bainey, Bobak Heydari, Janet Wei, Victoria Vaughan Dickson, Gbenga Ogedegbe, Jeffrey S Berger, Judith S Hochman, Harmony R Reynolds
JACC. Advances February 1, 2025 DOI: 10.1016/j.jacadv.2024.101530 via PubMed
Summary
AI-generated from the abstractA mindfulness-based intervention (MBCT-Brief) reduced stress more than heart disease education among women who had a myocardial infarction and reported elevated stress. In the main analysis, stress scores declined in the mindfulness group but not in the education group, though the difference between groups was not statistically significant. Among women who completed at least four sessions, the mindfulness group showed a significantly greater stress reduction. More frequent mindfulness practice was linked to larger decreases in stress, depressive symptoms, and anxiety. The study did not find significant differences between groups for depression, anxiety, quality of life, or sleep.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 130 |
| Population | Women with myocardial infarction and elevated perceived stress |
| Intervention | Heart disease education |
| Duration | 8-week intervention, 6-month follow-up |
| Topics | Meditation |
| Keywords | Clinical trial Myocardial infarction Stress Women |
| Citations | 4 |
| Key finding | Mindfulness training reduced stress more than heart disease education among women with myocardial infarction who adhered to the intervention, and more frequent practice was associated with greater improvements in psychological outcomes. |
Abstract
Elevated perceived stress is associated with adverse outcomes following myocardial infarction (MI) and may account for poorer recovery among women vs men. This randomized controlled trial tested effects of a mindfulness-based intervention on stress levels among women with MI. Women with elevated stress (Perceived Stress Scale [PSS-4]≥6) at least 2 months after MI were enrolled from 12 hospitals in the United States and Canada and via community advertising. Participants were randomized to a remotely delivered mindfulness intervention (MBCT-Brief) or heart disease education, both 8 weeks long. Follow-up was 6 months. Changes in stress (PSS-10; primary outcome) and secondary outcomes (depressive symptoms, anxiety, quality of life, disease-specific health status, actigraphy-assessed sleep) were compared between groups. The sample included 130 women with MI (mean age 59.8 ± 12.8 years, 34% racial/ethnic minorities). In intention-to-treat analysis, PSS-10 scores declined in the MBCT-Brief arm (-0.52 [95% CI: -0.77 to -0.28]) but not the heart disease education arm (-0.19 [95% CI: -0.45 to 0.06]; group×time interaction P = 0.070). The effect was stronger in per-protocol analysis of participants who completed ≥4 intervention sessions (P = 0.049). There were no significant differences in secondary outcomes in intention-to-treat or per-protocol analyses. Within the MBCT-Brief arm, more frequent mindfulness practice was associated with greater reductions in stress (P = 0.007), depressive symptoms (P = 0.017), and anxiety (P = 0.036). MBCT-Brief was associated with greater 6-month reductions in stress than an active control among adherent participants. More frequent mindfulness practice was associated with greater improvements in psychological outcomes. Strategies to engage women with MI in mindfulness training and support regular home practice may enhance these effects.