Remotely delivered mindfulness-based cognitive therapy for spontaneous coronary artery dissection survivors

After spontaneous coronary artery dissection (SCAD), 80% of survivor's experience fear of recurrence (FOR) which contributes to poorer clinical outcomes. Although FOR interventions (i.e. mindfulness-based cognitive therapy; MBCT) exist, none have been targeted to SCAD survivors.

To assess the feasibility, acceptability, and preliminary FOR effects of MBCT for SCAD survivors (UpBeat-MBCT).

In this single-arm feasibility study, SCAD survivors were recruited from a hospital clinic to participate in UpBeat-MBCT, an 8-week group intervention combining cognitive-behavioral therapy, mindfulness meditation, and health behavior promotion. Participants completed surveys of psychological and behavioral variables pre-post intervention, actigraphy, and daily diaries of sleep and physical activity for 7 days pre-post intervention. The primary outcomes were feasibility and acceptability. Exploratory outcomes included changes in psychological and behavioral variables.

SCAD survivors (N = 19) were enrolled across two sequential group cohorts (94% female, 95% non-Hispanic White, Mage = 51). In Cohort 1, results indicated that hearing about SCAD from others was emotionally activating and associated with high attrition (33% retained). Refinements for Cohort 2 included placing boundaries around group discussion, and 90% of participants were retained. Among retained participants across both cohorts (n = 12), program satisfaction was M = 8.3/10 (SD = 1.8), 91% (10/11) would recommend the program, and changes in FOR showed a medium-large effect size for improvement (d = 0.72).

UpBeat-MBCT is the first FOR intervention for SCAD survivors. When boundaries are set to guide discussion of SCAD, results support the feasibility, acceptability, and benefits of an MBCT group approach and the need for expanded testing.

The Clinical Trials Registration #: NCT04983680.