Management of Anger in Patients With Acute Myocardial Infarction (MAPAMI)

NCT02868216 | Completed Results

• 1 other identifier: UP4985/14
• Study Type: interventional
• Target: 90
• Locations: 0 countries
• Sites: N/A

Brief Summary

Stress, anger and depressed can operate as a trigger to an Acute Coronary Syndrome. It is often found in the literature that patients refer excessive anger, anxiety, sadness, pain or acute stress before the acute myocardial infarction (AMI). Moreover, a recent meta-analysis reported a strong association between the occurrence of AMI and many of these acute emotions. Anger is a common manifestation of psychological stress and could trigger off an atherogenic process through several mechanisms. Coronary atherosclerosis features narrowing of coronary arteries on account of endothelial thickening caused by the build up of atheromatous plaques. It is a process characterized by inflammatory and fibroproliferative response of the artery wall, caused by continuous aggression to its surface and whose thickening, evoked by the evolution of fat streaks atherosclerotic lesions, until fiber plaques is quite slow. Endothelial dysfunction also results in the loss of natural anti-thrombotic properties involved in the endothelium patency. According to a study performed by our group, anger management was significantly lower among patients with CAD when compared to those without CAD, and the occurrence of major cardiovascular events (MACE) was significantly higher in patients presented with lower anger control. Both associations were independent from traditional risk factors, occurrence of previous events or another anger aspects. Thus, this study was designed in order to evaluate the effect of the "cognitive training to anger management " on endothelium-dependent vasodilation of the arm artery in patients with acute myocardial infarction with ST segment elevation submitted to primary coronary intervention.

Conditions

Myocardial Infarction

Outcome Measures

Primary Outcomes (1)

• Difference in Flow-mediated Dilation in the Brachial Artery in the Base and After the Treatment.

  Inter group difference in flow-mediated dilation in the brachial artery in the baseline and after the treatment (about Three months after the first). Vasodilatation of the endothelium-dependent brachial artery was evaluated by ultrasound using a 3-12 MHz linear transducer. Three images of the basal diameter (BD) of the brachial artery at the end of the diastole were acquired, as well as the mean velocity of the baseline arterial flow, with the linear transducer positioned 5 cm above the antecubital fossa. Subsequently, the sphygmomanometer was placed in the arm and inflated 50 mmHg above baseline systolic blood pressure for five minutes. After that, 3 images of the arterial diameter were acquired up to 80 seconds of the deflation of the cuff (post-occlusion diameter- PD), as well as the average of the arterial flow velocity. Flow-dependent vasodilation responses were expressed as a percentage variation from the baseline brachial diameter (PD-BD/ BD x 100).

  three months after the first evaluation

Study Arms (2)

anger management training

EXPERIMENTAL

treatment group- Two monthly sessions will address the events triggering anger, the physiology of anger and the influence on the cardiovascular system, the dimesions of anger: cognitive, emotional and behavioral.

Behavioral: anger management training

Without management training

NO INTERVENTION

No anger management training

Interventions

anger management training BEHAVIORAL

anger management training

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• acute st elevation myocardial infarction

You may not qualify if:

• dementia, cognitive dysfunction,
• bypass surgery previous or during the study periods living from more 200 Km from hospital

Sponsors & Collaborators

• Instituto de Cardiologia do Rio Grande do Sul: lead

Related Publications (1)

• Schmidt KES, de Quadros AS, Eibel B, Aires AM, Gottschall CAM, Moura MRS, Schmidt MM. The Influence of Cognitive Behavioral Intervention for Anger Management on Endothelial Function in Patients With Recent Myocardial Infarction: A Randomized Clinical Trial. Psychosom Med. 2022 Feb-Mar 01;84(2):224-230. doi: 10.1097/PSY.0000000000001039.

  PMID: 34840289 DERIVED

MeSH Terms

Conditions

Myocardial Infarction

Interventions

Anger Management Therapy

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis

Intervention Hierarchy (Ancestors)

Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Results Point of Contact

• Title: Dra Marcia Moura Schmidt
• Organization: Cardiologia (Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology

mmoura22@terra.com.br

5551 32333600

Study Officials

• Marcia Moura Schmidt, PhD

  Instituto de Cardiologia do Rio Grande do Sul

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Blinding occurs only in relation to the evaluator of endothelial function
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: One group receives training for anger management, with guidance on infarction and physiology of anger and another group, does not receive.

Study Record Dates

• First Submitted: August 11, 2016
• First Posted: August 16, 2016
• Study Start: September 15, 2015
• Primary Completion: March 1, 2016
• Study Completion: July 15, 2017
• Last Updated: June 29, 2023
• Results First Posted: November 5, 2019

Record last verified: 2019-09

Data Sharing

• IPD Sharing: Will not share