Randomized Controlled Trial of Internet‐Delivered Cognitive Behavioral Therapy After Myocardial Infarction With Nonobstructive Coronary Arteries or Takotsubo Syndrome

15 Jun 20264 min read0 viewsJournal Feed

GIST (Key Takeaways)

Journal of the American Heart Association, Volume 15, Issue 12 , June 16, 2026. Background. Patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) or Takotsubo syndrome (TS) often suffer from poor mental health and low quality‐of‐life post event, with no current evidence‐based treatments available. This study aimed to evaluate the effects of an internet‐delivered cognitive behavioral therapy program on stress and anxiety symptoms in patients diagnosed with myocardial infarction with nonobstructive coronary arteries or TS.Methods.
A parallel, multicenter, randomized controlled trial with a wait‐list control group was conducted. Patients with elevated symptoms of stress or anxiety were included (the 14‐item perceived stress scale ≥25 or hospital anxiety and depression scale, anxiety subscale ≥8). The primary outcome was normalized stress and anxiety levels 10 to 12 weeks after randomization. Secondary outcomes included normalized stress and anxiety separately and symptoms as continuous measures.
Results. A total of 88 patients were randomized (treatment: 45, control: 43). The treatment group showed a greater, though not statistically significant proportion of normalized patients (odds ratio, 2.37 [95% CI, 0.88–6.38],P=0.09). Secondary analyses indicated treatment effects on anxiety normalization and on symptoms as continuous measures (effect sizes: d=0.44–0.67).
There was also an interaction between treatment and diagnosis (TS versus non‐TS), favoring a treatment effect in TS patients (P=0.016).Conclusions. The patient‐tailored internet‐delivered cognitive behavioral therapy program reduced stress and anxiety symptoms in patients with myocardial infarction with nonobstructive coronary arteries or TS and normalized anxiety symptoms in a greater proportion of treated patients than controls. Exploratory analyses indicated that patients with TS may experience greater benefit from the internet‐delivered cognitive behavioral therapy intervention, but this warrants further research.

Clinical Editorial

Journal of the American Heart Association published a clinical update in Cardiology on 15 Jun 2026. The item focuses on Randomized Controlled Trial of Internet‐Delivered Cognitive Behavioral Therapy After Myocardial Infarction With Nonobstructive Coronary Arteries or Takotsubo Syndrome. Open the detail page to review the full original feed content.