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

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Duke Health News 919-660-1306

DALLAS, TX -- 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.

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