Coronary heart disease in the leading cause of death, disability, and health care costs in the US. Among patients with established coronary heart disease (CHD), a majority of patients continue to have acute cardiac events, many sudden and unexpected, despite identification and treatment of their disease and traditional risk factors. Substantial evidence indicates that psychosocial stress and the sympathetic nervous system contributes to acute cardiac events. Preliminary evidence suggests that complementary medicine practices, such as traditional acupuncture (TA), may beneficially alter outcomes in patients with CHD, although the mechanisms responsible for the observed benefit are unknown. We propose to conduct a randomized, blinded, controlled study of the effects of the complementary medicine practice of traditional acupuncture (TA) compared to sham TA and waiting control group on the primary outcome of: 1) autonomic nervous system imbalance (heart rate variability);and the secondary outcomes of: 2) an inflammatory marker (high-sensitivity C reactive protein);and 3) psychological stress, depression, hostility, anxiety, social support, and quality of life;and the exploratory variable of arterial vasomotion (brachial artery reactivity testing). We hypothesize that the complementary medicine practice of TA can serve as an additive/alternative treatment for the prevention of acute cardiac events in CHD patients. The results of this randomized controlled trial will: a) yield new data regarding the pathophysiologic mechanisms effected by the complementary medicine practice of TA in CHD patients, and b) provide pilot data for a large multi-center study of the effect of TA on acute CHD events, including sudden cardiac death.
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