In 1977 the Recurrent Coronary Prevention Project (RCPP) enrolled 1012 post-myocardial infarction subjects to assess over 5 years if (1) the Type A (coronary prone) behavior pattern could be significantly modified, and (2) if reductions in Type A were directly related to reduced coronary recurrences. After 4 1/2 years, intervention was discontinued upon NHLBI recommendation because highly significant reductions in coronary recurrence and Type A behavior had been demonstrated for the experimental condition compared to control as well as comparison conditions. The proposed research will examine the stability of these changes 3 1/2 years after treatment ended in 849 subjects who currently remain available. Two major objectives are to examine if: (1) the significantly lower total coronary recurrence rate is maintained by subjects who received the behavioral plus cardiologic treatment (experimental condition) vs. subjects in the cardiologic only treatment (control condition), (2) reductions in Type A behavior are maintained or further reduced and generalized by subjects in the experimental vs. control condition. Minor objectives include: (1) study of anger-hostility in predicting recurrences and changes in other psychosocial measures over 8 years, (2) possible dose-response relationships between amount of treatment received and recurrence rate as well as changes on psychosocial indices, (3) further study of significantly lower recurrence rate found for experimental subjects who entered study with coronary bypass surgery compared to bypass subjects in the control group; also further study of same finding for beta blocker medication use by subjects at entry, (4) study of quality of life indices to see if major differences at followup exist between conditions, and if subjects are currently utilizing skills and information acquired in the RCPP.
| Powell, L H; Shaker, L A; Jones, B A et al. (1993) Psychosocial predictors of mortality in 83 women with premature acute myocardial infarction. Psychosom Med 55:426-33 |
