Music, imagery, touch, and prayer as adjuncts to interventional cardiac care: the Monitoring and Actualisation of Noetic Trainings (MANTRA) II randomised study.
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 2x2 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.


RESULTS
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).


CONCLUSIONS
Neither masked prayer nor MIT therapy significantly improved clinical outcome after elective catheterisation or percutaneous coronary intervention.
Krucoff
Mitchell W
MW
Duke Clinical Research Institute, Durham, NC 27705, USA. kruco001@mc.duke.edu
Crater
Suzanne W
SW
Gallup
Dianne
D
Blankenship
James C
JC
Cuffe
Michael
M
Guarneri
Mimi
M
Krieger
Richard A
RA
Kshettry
Vib R
VR
Morris
Kenneth
K
Oz
Mehmet
M
Pichard
Augusto
A
Sketch
Michael H
MH
Koenig
Harold G
HG
Mark
Daniel
D
Lee
Kerry L
KL
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization; D002318:Cardiovascular Diseases / Q000401:mortality; D003327:Coronary Disease / Q000523:psychology / Q000628:therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D019018:Imagery, Psychotherapy; D008297:Male; D008875:Middle Aged; D026441:Mind-Body Therapies; D009146:Music; D012008:Recurrence; D026443:Spiritual Therapies; D019124:Therapeutic Touch; D016896:Treatment Outcome