Evidence map›Paper›PMID 27045127›Full record

Trial reportCirculation2016

Enhancing Cardiac Rehabilitation With Stress Management Training: A Randomized, Clinical Efficacy Trial.

James A Blumenthal, Andrew Sherwood, Patrick J Smith, Lana Watkins, Stephanie Mabe, William E Kraus, Krista Ingle, Paula Miller, Alan Hinderliter

3 registry-linked trialsOpen access · greenAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 131 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
131citing papers in PubMed, 11 pooled it
17.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00981253 nacompletednot on this map

Enhancing Standard Cardiac Rehabilitation With Stress Management Training in Patients With Heart Disease

TypeinterventionalSponsorDuke UniversityRan2009 to 2016Enrolled164ConditionsCoronary Heart DiseaseArmsSMT-enhanced Cardiac Rehabilitation, Standard Cardiac Rehabilitation
NCT04254315 nacompletednot on this mapstarted 2019, after this paper: background citation

OPTIMA: Psychological Distress and the Effect of Intensive Group Based Cognitive Therapy in Patients With Newly Diagnosed Ischemic Heart Disease: A Randomised Controlled Trial Protocol

TypeinterventionalSponsorUniversity Hospital Bispebjerg and FrederiksbergRan2019 to 2022Enrolled188ConditionsIschemic Heart Disease, Heart Valve Diseases, Psychological DistressArmsGroup based cognitive therapy
NCT05532605 naunknown statusnot on this mapstarted 2022, after this paper: background citation

Effects of Mindfulness Based Therapy on Patients Perception of Illness and Depression in Cardiac Rehabilitation Phase-i

TypeinterventionalSponsorRiphah International UniversityRan2022 to 2023Enrolled48ConditionsCoronary Artery StenosisArmscardiac rehabilitation phase I protocols, Cardiac rehab phase I protocols + Mindfullness base therapy
3 · Its place in the literature

Who cites it

131 citing papers in PubMed, 11 syntheses or guidelines pooled it, 250 citations in OpenAlex.

  1. Guideline
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  7. Mindfulness-Based Interventions for Adults with Cardiovascular Disease: A Systematic Review and Meta-Analysis.Annals of behavioral medicine : a publication of the Society of Behavioral Medicine · 2020
    Pooled it
  8. Pooled it
  9. Interventions to promote patient utilisation of cardiac rehabilitation.The Cochrane database of systematic reviews · 2019
    Pooled it
  10. Psychological interventions for coronary heart disease.The Cochrane database of systematic reviews · 2017
    Pooled it
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  12. Trial
  13. Effects of cardiac rehabilitation with and without meditation on myocardial blood flow using quantitative positron emission tomography: A pilot study.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021
    Trial
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71 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

James A BlumenthalFrom the Departments of Psychiatry and Behavioral Sciences (J.A.B., A.S., P.J.S., L.W., S.M., K.I.) and Medicine (W.E.K.), Duke University Medical Center, Durham, NC; and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (P.M., A.H.). blume003@mc.duke.edu.
Andrew SherwoodFrom the Departments of Psychiatry and Behavioral Sciences (J.A.B., A.S., P.J.S., L.W., S.M., K.I.) and Medicine (W.E.K.), Duke University Medical Center, Durham, NC; and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (P.M., A.H.).
Patrick J SmithFrom the Departments of Psychiatry and Behavioral Sciences (J.A.B., A.S., P.J.S., L.W., S.M., K.I.) and Medicine (W.E.K.), Duke University Medical Center, Durham, NC; and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (P.M., A.H.).
Lana WatkinsFrom the Departments of Psychiatry and Behavioral Sciences (J.A.B., A.S., P.J.S., L.W., S.M., K.I.) and Medicine (W.E.K.), Duke University Medical Center, Durham, NC; and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (P.M., A.H.).
Stephanie MabeFrom the Departments of Psychiatry and Behavioral Sciences (J.A.B., A.S., P.J.S., L.W., S.M., K.I.) and Medicine (W.E.K.), Duke University Medical Center, Durham, NC; and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (P.M., A.H.).
William E KrausFrom the Departments of Psychiatry and Behavioral Sciences (J.A.B., A.S., P.J.S., L.W., S.M., K.I.) and Medicine (W.E.K.), Duke University Medical Center, Durham, NC; and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (P.M., A.H.).
Krista IngleFrom the Departments of Psychiatry and Behavioral Sciences (J.A.B., A.S., P.J.S., L.W., S.M., K.I.) and Medicine (W.E.K.), Duke University Medical Center, Durham, NC; and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (P.M., A.H.).
Paula MillerFrom the Departments of Psychiatry and Behavioral Sciences (J.A.B., A.S., P.J.S., L.W., S.M., K.I.) and Medicine (W.E.K.), Duke University Medical Center, Durham, NC; and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (P.M., A.H.).
Alan HinderliterFrom the Departments of Psychiatry and Behavioral Sciences (J.A.B., A.S., P.J.S., L.W., S.M., K.I.) and Medicine (W.E.K.), Duke University Medical Center, Durham, NC; and Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill (P.M., A.H.).
University of North Carolina at Chapel Hill · US

Funding

Stress Management and Biomarkers of Risk in Cardiac RehabilitationR01HL093374 · NHLBI · DUKE UNIVERSITY · PI BLUMENTHAL, JAMES A · 2009 to 2014
$3.7M
NHLBI NIH HHS HL093374NHLBI NIH HHS R01 HL093374
6 · The paper itself

Abstract

backgroundCardiac rehabilitation (CR) is the standard of care for patients with coronary heart disease. Despite considerable epidemiological evidence that high stress is associated with worse health outcomes, stress management training (SMT) is not included routinely as a component of CR. METHODS AND

resultsOne hundred fifty-one outpatients with coronary heart disease who were 36 to 84 years of age were randomized to 12 weeks of comprehensive CR or comprehensive CR combined with SMT (CR+SMT), with assessments of stress and coronary heart disease biomarkers obtained before and after treatment. A matched sample of CR-eligible patients who did not receive CR made up the no-CR comparison group. All participants were followed up for up to 5.3 years (median, 3.2 years) for clinical events. Patients randomized to CR+SMT exhibited greater reductions in composite stress levels compared with those randomized to CR alone (P=0.022), an effect that was driven primarily by improvements in anxiety, distress, and perceived stress. Both CR groups achieved significant, and comparable, improvements in coronary heart disease biomarkers. Participants in the CR+SMT group exhibited lower rates of clinical events compared with those in the CR-alone group (18% versus 33%; hazard ratio=0.49; 95% confidence interval, 0.25-0.95; P=0.035), and both CR groups had lower event rates compared with the no-CR group (47%; hazard ratio=0.44; 95% confidence interval, 0.27-0.71; P<0.001).

conclusionsCR enhanced by SMT produced significant reductions in stress and greater improvements in medical outcomes compared with standard CR. Our findings indicate that SMT may provide incremental benefit when combined with comprehensive CR and suggest that SMT should be incorporated routinely into CR. CLINICAL

trial registrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00981253.

Indexed as

Psychotherapy, GroupAgedAngina, UnstableBaroreflexCardiovascular AgentsCognitive Behavioral TherapyCombined Modality TherapyCoronary DiseaseCounselingC-Reactive ProteinExercise TestFemaleHumansLipidsMaleMiddle AgedCardiovascular AgentsC-Reactive ProteinLipidscoronary diseaseepidemiologyexerciserehabilitationstress, psychological

Identifiers

PMID27045127
PMCPMC4824555
OpenAlexW2304409582

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.