Effects of psychological interventions on clinical outcomes in patients with cardiovascular diseases: A systematic review and meta-analysis

Objective: To perform a systematic review and meta-analysis to evaluate the effects of psychological interventions on the clinical outcomes of patients with cardiovascular diseases (CVDs). Methods: We searched PubMed, Web of Science, Embase, the Cochrane Library, and CINAHL from the establishment of each database to August 1, 2023. Randomized controlled trials (RCTs) on psychological interventions in patients with CVDs were included. Statistical analyses were performed using Review Manager 5.3 and Stata 17.0, and pooled measures were presented as the relative risk (RR) and 95 % confidence interval (CI). Results: A total of 32 studies were included, involving 15,814 patients. Our results showed that psychological interventions could reduce cardiac mortality (RR = 0.81, 95 % CI = 0.68 to 0.96) and the occurrence of myocardial infarction (MI) (RR = 0.79, 95% CI = 0.69 to 0.89), arrhythmia (RR = 0.61, 95 % CI = 0.42 to 0.89) and angina (RR = 0.92, 95 % CI = 0.87 to 0.97). However, no statistically significant differences were detected in the risk of all-cause mortality, all-cause rehospitalization rates, cardiac rehospitalization rates, revascularization, heart failure (HF), or stroke between the psychological intervention and control groups. Conclusions: Psychological interventions can reduce cardiac mortality and the occurrence of MI, arrhythmia, and angina in patients with CVDs. It is crucial to incorporate psychological interventions into the existing treatment and management of patients with CVDs. High-quality RCTs should be conducted to explore the optimal psychological intervention methods and the maximum beneficiaries.