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Enrolling by invitationNCT04223882Updated Jun 29, 2023

Stress Management in Patients With Coronary Artery Disease

An interventional study of Management of Stress and Usual care in Stress, Psychological, sponsored by Instituto de Cardiologia do Rio Grande do Sul. Enrolling by invitation at 1 site in Brazil. Open to participants aged 18 Years to 79 Years. Per ClinicalTrials.gov, last updated 2023-06-29.

Sponsored by Instituto de Cardiologia do Rio Grande do Sul · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
90
Allocation
Randomized
Ages
18 Years to 79 Years
Sex
All
01

Study summary

Introduction: Stress can cause hemodynamic and metabolic changes that contribute to endothelial dysfunction and there is a significant association between high stress and cardiovascular events. Objective: To evaluate the influence of stress management on endothelial function in patients undergoing percutaneous coronary intervention (PCI). Methods: Randomized, controlled, parallel, intention-to-treat clinical trial. Will be considered eligible patients who underwent percutaneous coronary intervention and who have high stress (above average for the Brazilian population) in the Perceived Stress Scale (PSS-10). Patients will be evaluated on PCI admission and stress management with cognitive behavioral techniques will be implemented one month after hospital discharge in the intervention group. Group sessions will be held between 6-9 people. There will be 4 1-hour meetings for 8 weeks. The primary outcome will be the difference in the variation of brachial artery flow-mediated dilatation (FMD) between the groups and at 3 months of baseline evaluation and at 6-month follow-up after the intervention and the secondary outcome will be the difference in the variation of the velocity of brachial artery. Pulse wave evaluated at the same time periods as DMF. Outcomes will be evaluated by Generalized Estimation Equations (GEE). Expected Results: In patients undergoing high-stress percutaneous coronary intervention, the use of cognitive behavioral techniques for stress management will improve endothelial function and vascular stiffness.

02

Conditions studied

  • Stress, Psychological

Keywords

  • Stress, Psychological;
  • Coronary Artery Disease;
  • Percutaneous Coronary Intervention;
  • Endothelium;
03

In context

Coronary Artery Disease

5,598 studies on the registry are indexed under Coronary Artery Disease; 957 are open to participants now.

This study's planned enrollment of 90 is below the median of 124 across 3,436 interventional studies indexed under Coronary Artery Disease.

Browse Coronary Artery Disease studies →

Lead sponsor

Instituto de Cardiologia do Rio Grande do Sul is the lead sponsor of 74 studies on the registry; 10 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 79 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age ≥ 18 years;
  • Patients with CAD - obstruction of one or more epicardial arteries with at least 70% stenosis and / or Left Coronary Trunk (TBI) with at least 50% - measured by catheterization (CATE) and having performed elective PCI
  • High stress: above average score for the Brazilian population in the Perceived Stress Scale (PSS-10)
  • Signing of the Informed Consent.

Exclusion criteria

Exclusion Criteria:

  • Age ≥ 80 years
  • Patients with inpatient events (AMI, CABG, stroke)
  • Indication of catheterization for valvulopathies or congenital heart disease
  • Severe aortic stenosis / Ejection fraction \<30%, cardiomyopathy, severe congestive heart disease
  • Severe diseases with life expectancy \<6 months
  • Cognitive or mental difficulties to understand the instrument
  • Inability to follow up visits
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
90 participants (estimated)

Study arms

  • Experimental
    Group Intervention- Management of stress

    Patients in the intervention group will receive usual medical care and more stress management intervention. Stress management with cognitive behavioral techniques will be implemented one month after hospital discharge in the intervention group. Group sessions will be held between 6-9 people. There will be 3 1-hour meetings for 3 weeks. The intervention will be performed by psychologist.

    Behavioral: Management of Stress

  • Active comparator
    Group Control

    Patients in the control group will receive usual medical care.

    Other: Usual care

Interventions

  • BehavioralManagement of Stress

    Psychoeducation: Coronary artery disease, Percutaneous Coronary Intervention, traditional risk factors and emotional stress. Stress: physiology, triggers, triad (thinking, emotion, action). Skills training: Identify warning signs - signs and symptoms; Monitoring of irrational automatic thoughts generating alternative interpretations of situations or unrealistic thinking patterns (Dysfunctional Thinking Records Sheet). Self-control for stress management: Assertiveness training, problem solving. Thought-stopping technique, designed for dysfunctional thoughts, such as, "I won't do it," "It won't work." Stress Relief / Control Techniques: Diaphragmatic Breathing: Expansion of the abdomen rather than the chest when breathing. Progressive Muscle Relaxation: Maximize tension and alternately relax the muscles (legs, abdomen, chest, arms and face).

  • OtherUsual care

    outpatient medical appointments

    Also known as: Patients in the control group will receive usual medical care

06

What researchers measure

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).

    Time frame: Three months after the first evaluation

07

Study locations

1 site
  • Marcia Moura Schmidt
    Porto Alegre, Rio Grande Do Sul 90620-000, Brazil
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 29, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04223882
Lead sponsor
Instituto de Cardiologia do Rio Grande do Sul
Responsible party
Sponsor
First posted
Jan 10, 2020
Start date
Oct 5, 2022
Primary completion
Jan 5, 2023
Completion
Oct 5, 2023 (estimated)
Last update
Jun 29, 2023

Study contacts

Marcia Moura Schmidt, PhD
study director · Instituto de Cardiologia do Rio Grande do Sul
Karine Elisa Schwarzer Schmidt
principal investigator · Instituto de Cardiologia do Rio Grande do Sul

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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