以音乐、意象、感觉和祈祷作为心脏介入的辅助手段:MANTRA(认知训练的监测和实施)II期随机研究

来源 :世界核心医学期刊文摘(心脏病学分册) | 被引量 : 0次 | 上传用户:fuji2009
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Background: Data from a pilot study suggested that noetic therapies -healing practices that are not mediated by tangible elements -can reduce preprocedural distress and might affect outcomes in patients undergoing percutaneous coronary intervention. We undertook a multicentre, prospective trial of two such practices: intercessory prayer and music, imagery, and touch(MIT) therapy. Methods: 748 patients undergoing percutaneous coronary intervention or elective catheterisation in nine USA centres were assigned in a 2×2 factorial randomisation either off-site prayer by established congregations of various religions or no off-site prayer(double-blinded) and MIT therapy or none(unmasked). The primary endpoint was combined in-hospital major adverse cardiovascular events and 6-month readmission or death. Prespecified secondary endpoints were 6-month major adverse cardiovascular events, 6 month death or readmission, and 6-month mortality. Findings: 371 patients were assigned prayer and 377 no prayer; 374 were assigned MIT therapy and 374 no MIT therapy. The factorial distribution was: standard care only, 192; prayer only, 182; MIT therapy only, 185; and both prayer and MIT therapy, 189. No significant difference was found for the primary composite endpoint in any treatment comparison. Mortality at 6 months was lower with MIT therapy than with no MIT therapy(hazard ratio 0.35,95%CI 0.15-0.82, p=0.016). Interpretation: Neither masked prayer nor MIT therapy significantly improved clinical outcome after elective catheterisation or percutaneous coronary intervention. Background: Data from a pilot study suggested that noetic therapies -healing practices that are not mediated by tangible elements-can reduce preprocedural distress and might affect outcomes in patients undergoing percutaneous coronary intervention. We undertook a multicentre, prospective trial of two such practices: intercessory Methods: 748 patients undergoing percutaneous coronary intervention or elective catheterisation in nine USA centers were assigned in a 2 × 2 factorial randomisation either off-site prayer by established congregations of various religions or no The primary endpoint was combined in-hospital major adverse cardiovascular events and 6-month readmission or death. Prespecified secondary endpoints were 6-month major adverse cardiovascular events, 6 month death or readmission, and 6-month mortality. Findings: 371 patients were assigned prayer and 377 no 374 were assigned MIT therapy and 374 no MIT therapy. The factorial distribution was: standard care only, 192; prayer only, 182; MIT therapy only, 185; and both prayer and MIT therapy, 189. No significant difference was found for The primary composite endpoint in any treatment comparison. Mortality at 6 months was lower with MIT therapy than with no MIT therapy (hazard ratio 0.35, 95% CI 0.15-0.82, p = 0.016). Interpretation: Neither masked prayer nor MIT therapy significantly improved clinical outcome after elective catheterisation or percutaneous coronary intervention.
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