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Published on: January 28, 2020
Impact of optimism training on atherosclerotic biomarkers in coronary artery disease: A randomized controlled trial
Masoumeh Sadeghi1, Nasim Kakavand1, Mohammadesmaeil Aramesh Boroujeni2
1Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Optimism training improved psychological health in cardiac patients but had minimal, uncertain effects on adhesion molecules like ICAM-1 and VCAM-1. Larger studies are needed to confirm clinical significance.
Area of Science:
- Cardiovascular Medicine
- Psychoneuroimmunology
- Biomarker Research
Background:
- Atherosclerosis, a chronic inflammatory disease, drives cardiovascular disease (CVD) mortality.
- Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) are key in atherosclerosis development.
- The impact of optimism interventions on these adhesion molecules is not well-understood.
Purpose of the Study:
- To investigate the effect of an optimism-based intervention on ICAM-1 and VCM-1 levels in coronary artery disease (CAD) patients.
- To assess psychological changes, including depression, anxiety, and negative affect, following the intervention.
Main Methods:
- A randomized controlled trial with 61 stable CAD patients post-cardiac rehabilitation.
- An eight-week group-based optimism training program versus an attention-matched control group.
- Measurement of plasma ICAM-1 and VCAM-1 via ELISA at baseline and 16 weeks; psychological assessments.
Main Results:
- Optimism intervention significantly reduced depression, anxiety, and negative affect (p < 0.05).
- Small, inconclusive between-group differences in adhesion molecule levels were observed post-intervention.
- No significant group-by-time interactions or correlations between optimism changes and adhesion molecule levels.
Conclusions:
- Optimism interventions offer psychological benefits for CAD patients.
- Observed changes in adhesion molecule biomarkers (ICAM-1, VCAM-1) were minor and uncertain.
- Further research with larger sample sizes is necessary to clarify the clinical relevance of these findings due to high biomarker variability.
Background:
Atherosclerosis, a chronic inflammatory condition, is the leading cause of cardiovascular disease (CVD) morbidity and mortality worldwide. Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) are key mediators of leukocyte-endothelial interactions and drivers of atherosclerotic progression. While optimism-based psychological interventions have demonstrated beneficial effects on several inflammatory biomarkers, their impact on adhesion molecules remains unclear.
Methods:
We conducted a randomized controlled trial involving 61 outpatients with stable coronary artery disease (CAD) who had completed cardiac rehabilitation. Participants were randomized to an eight-week group-based optimism training program or an attention-matched cardiac education control. Changes in plasma ICAM-1 and VCAM-1 levels were measured by ELISA at baseline and 16 weeks as well as psychological measures of depression, anxiety, and negative affect.
Results:
The optimism intervention significantly improved psychological outcomes, with reductions in depression, anxiety, and negative affect compared to controls (p < 0.05). While post-intervention adhesion molecule levels showed significant between-group differences, effect sizes were small and inconclusive, with no significant group-by-time interactions. Correlation analyses found no significant link between changes in optimism and adhesion molecule levels.
Conclusions:
Optimism-based interventions yield meaningful psychological benefits in patients with CAD, though changes in adhesion molecule biomarkers were small and uncertain. High variability in biomarker levels and limited detectable effect sizes highlight the need for larger studies to clarify the clinical significance of these findings.
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