Health . Spirituality . Cardiac Patients and Prayer

Use of Prayer or Noetic Therapy May Contribute to Better Outcomes in Cardiac Patients

DALLAS -- Combining prayer with traditional treatments may offer the best medicine of all, say researchers who tested the power of spirituality to affect the outcome of heart patients undergoing coronary balloon angioplasty.

In a feasibility study conducted by the Duke University and Durham Veterans Affairs medical centers, angioplasty patients with acute coronary syndromes who were simultaneously prayed for by seven different religious sects around the world did 50 percent to 100 percent better during their hospital stay than patients who were not prayed for by these groups.

Other angioplasty patients who received either touch therapy, stress relaxation or guided imagery showed a 30 percent to 50 percent trend of improved outcomes during hospitalization compared to patients who didn't receive such "noetic" therapies, the researchers found.

Although the feasibility study of 150 patients was too small to offer statistically significant comparisons, the results "are highly intriguing, and not what most traditional physicians would have expected," said Duke cardiologist Dr. Mitch Krucoff, who conducted the study with nurse practitioner Suzanne Crater and 22 volunteers. Krucoff and Crater prepared the findings of the trial, known as MANTRA (Monitor and Actualization of Noetic TRAinings), for presentation at the 71st annual scientific sessions of the American Heart Association (AHA).

"Our data show beneficial trends," Krucoff said in an interview. "Our goal was to conduct as scientifically rigorous and reasonable a trial as has ever been undertaken to look at what else, besides pills and procedures, might help us treat patients."

A larger 1,500-patient trial is expected to start soon at five centers: Duke, the Durham VAMC, Scripps Clinic in San Diego, the Washington Heart Center in Washington and Baptist Medical Center in Oklahoma City

MANTRA was designed to use objective physiological measurements, such as continuous EEG monitoring, heart rate, blood pressure and clinical outcomes, to characterize the effects of spiritual energy in cardiac patients before, during and after invasive catheter procedures. It tested prayer and noetic therapies -- interventions that do not use drugs, devices or surgery -- on a group of 150 patients at the Durham VAMC. The procedure, which involves threading a tube into the heart while a patient is awake, is used either to collect images of the heart or to clear clogged arteries. It is a procedure that many patients find stressful and which carries medical risks -- a population ripe for a little relaxation or other beneficial therapy, the researchers believe.

In the study, Crater randomized the patients into one of five treatment arms. If they received prayer, she sent electronic mail to such sites as Virtual Jerusalem, so that a prayer could be inserted in that city's Wailing Wall, and to Buddhist monasteries in Nepal and France. She called Carmelite nuns in Baltimore, who offered a prayer during that evening's Vespers, as well as Fundamentalists and Moravians. These groups, plus Baptists and Unitarians, all prayed for the patient by name. The study was "double-blinded," meaning neither the patients nor their staff knew of their treatment assignments.

If the patient received a bedside noetic therapy, Crater paired that person up with one of 22 volunteers who either provided guided imagery, touch therapy or stress relaxation.

Without even knowing the results, Crater said the experience she had in offering patients something to help sooth the nerves of patients about to undergo a catheterization was dramatic enough "to change my practice. It is possible to bring a calming, healing space into a hospital, which can sometimes seem cold and sterile." Of the 170 patients she approached to participate in the trial, only 21 were not interested and only one of them refused to be prayed for by a variety of sects. "Most of them were very accepting of these therapies and I think that paid off in their outcome."

Krucoff and Crater conducted the research with the support of Marquette Electronics in Milwaukee, which provided a unique physiologic monitoring system. They collected information on how the patients did during their hospitalization, which they presented at the AHA, and they collected data on each patient's blood pressure and heart rate during the procedure and hospitalization, which they are still tabulating. They also looked at what happened during the time the 30 patients in each of the five arms was hospitalized. They looked at whether the patient experienced an adverse "event' defined as a heart attack, death, a second cardiac procedure, pulmonary edema or congestive heart failure.

Findings in the AHA report showed beneficial trends favoring the patients treated with any noetic therapy over standard care. Of the individual noetic therapies, the double-blinded, off-site prayer had the most therapeutic effects, although every noetic therapy had better outcomes than standard care.

"This makes us comfortable that these therapies at least are safe in this patient population, and it suggests that there may be therapeutic benefit, as well," Krucoff said.

Krucoff cautioned that it is important to understand the limitations of any clinical trial design relative to the effect being studied.

"We are not studying whether or not prayer works, because no one can do that unless someone invents a prayer-proof room. What we are studying is whether there is any incremental benefit -- over and above the prayers many of our patients and staff say routinely - from the systematic addition of specific noetic interventions in the midst of acute coronary instability."



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