This trial is evaluating whether Adapted MBCT will improve 8 primary outcomes and 15 secondary outcomes in patients with Acute Coronary Syndrome. Measurement will happen over the course of 6 months.
This trial requires 50 total participants across 2 different treatment groups
This trial involves 2 different treatments. Adapted MBCT is the primary treatment being studied. Participants will be divided into 2 treatment groups. There is no placebo group. The treatments being tested are not being studied for commercial purposes.
Most patients with non-ST-segment-elevation acute coronary syndrome who receive thrombolysis benefit within 2 weeks of the onset of symptoms and meet the definitions of myocardial infarction.
ACS are common. Most people of all ages experience them, and their frequency is increasing. In many cases, the symptoms are subtle and not noticed by the health care provider until significant coronary plaque rupture and/or thrombosis has occurred. ACS management and patient care in this setting can be challenging and a high level of expertise is highly recommended.
The majority of patients display transient ST elevation abnormalities consistent with acute coronary syndrome. However, a significant number of patients with ST elevation have no significant coronary artery stenosis. ST elevation may be a marker of other subclinical cardiac conditions such as transient ischaemic attack or stable ischaemic heart disease. Recent findings a large proportion (21%) of patients had transient ischaemic attacks. Furthermore, the majority had atherothrombotic events prior to their clinical presentation.
A large percentage of patients had acute coronary syndrome, and coronary artery bypass surgery was the most common treatment. In severe cases, open heart surgery were utilized. Coronary arteries were most commonly targeted during percutaneous coronary intervention. Targeted therapeutic therapies for acute coronary syndrome have also become increasingly common.
The vast majority of patients with non-ST-elevation myocardial infarction have chest pain rather than an acute coronary syndrome. The diagnosis of ACS based on symptoms alone seems to be unreliable. For instance, the sensitivity of chest pain for ACS at a primary care level is very low. An adequate investigation is recommended for all patients with non-ST-elevation myocardial infarction to prevent underdiagnosis.
It is not clear what causes acute coronary syndrome in all patients presenting to the emergency department with new-onset chest pain, left bundle-branch block, or positive Troponin. In most patients, there is a combination of risk factors.
This is the first randomized, controlled trial of adapted mbct for A* ACS patients, and results are promising. Although the study lacked in statistical power, these results indicate that adaptation to self-management interventions such as mbct for A* ACS patients can have improved outcomes for patients and provide some support for implementing additional adaptation to existing patient education programs for patients with ACS.
Adapted MBCT has a relatively high rate of side effects, and in some cases serious side effects have occurred. We think that some adaptations in the protocols may help. One problem is that there is no consensus over the definition of a side effect and the most effective means of preventing them as well. For example, we think that some patients may wish for an enlarged prostate which is not an appropriate adaptation if it is considered a serious side effect.
There are several factors relating to age, sex, and location that affect treatment decisions in patients hospitalized with an uncomplicated acute myocardial infarction being treated with standard medication and protocol. These factors have been shown to be helpful in determining the optimal timing of invasive procedures. The data showed that more patients may benefit from an early invasive approach than from a conservative medical treatment. These considerations should be considered in deciding when to do an invasive exam.
This is the first study where a large number of patients have been evaluated for their treatment choice after mbct, and it highlights the utility of adapted treatment in combination with other therapies. However, it also shows that many patients with a high-risk profile are not being offered mbct in primary PCI, perhaps a result of the complexity of choosing the correct treatment for their circumstances. This finding needs to be considered in our practice.
Treatment with Adapted MBCT is associated with a significant reduction on hospital readmission in patients with CABG/AADK. Findings from a recent study highlights the important role of adapted mbct in reducing readmissions after CABG/AADK.
In [the hospital in which we conduct the research(s)], we found that [adapted mbct] is not uncommon in patients with a myocardial infarction. When a patient is transferred to cardiology-related wards on a Wednesday, mbct may be [used] at [the next appointment] and [the patient will] be [attempted to return to their [previous workplace]].