title: Brief strategic therapy in first myocardial infarction patients with increased levels of stress: a randomized clinical trial.
abstract: BACKGROUND
  Little is known about the impact of interventions targeting chronic stress levels on clinical outcomes among myocardial infarction (MI) patients with increased levels of stress.
  
  
  OBJECTIVE
  To examine the impact of the addition of brief strategic therapy (BST) to usual care (UC) on clinical outcomes in first MI patients with increased levels of stress.
  
  
  METHODS
  Eighty-one patients were randomly assigned to BST in conjunction with UC (medical treatment, risk factor information, and guidance on unhealthy behavior change) or to UC.
  
  
  METHODS
  The outcome measures were scores on the Perceived Stress Scale, reinfarction and cardiac mortality rates, and scores on the Health Survey. Measures were taken before, post-treatment, and at two follow-ups.
  
  
  RESULTS
  Patients subjected to BST showed reduced perceived stress at post-treatment and maintained decreased levels at follow-ups. At 1-year follow-up, they had a lower rate of non-fatal reinfarction, and at 2.5-year follow-up, they had a lower rate of fatal reinfarction. Their mental and physical health was improved at post-treatment and this was sustained at follow-ups.
  
  
  CONCLUSIONS
  The addition of BST to UC favorably influences the disease course after MI in patients with increased levels of stress.
authors.affiliation: a Department of Psychopathology and Psychotherapy, Faculty of Psychology , University of Warsaw , Warsaw , Poland.
authors.forename: Jadwiga Małgorzata
authors.initials: JM
authors.lastname: Rakowska
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000517:prevention & control* / Q000523:psychology*; D012008:Recurrence; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D013997:Time Factors
keywords: brief strategic therapy; fatal reinfarction; first myocardial infarction patients with increased levels of perceived stress; mental and physical health status; non-fatal reinfarction