Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
Complementary Alternative Cardiovascular Medicine
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Chapter 9 /Prayer and CVD 145<br />
receiving noetic interventions, although these differences had wide confidence<br />
intervals and were not statistically significant. The greatest<br />
magnitude of absolute reduction in MACE was seen in the patients who<br />
were treated with prayer.<br />
The MANTRA Pilot studied the most homogeneous group of patients<br />
among these reported cardiac randomized trials, with a focus on patients<br />
with acute coronary disease undergoing invasive catheter-based procedures.<br />
In addition to this more focused patient cohort, the study systematically<br />
followed nonstudy related patient, family, and chaplain prayer<br />
said before the angioplasty, reporting the presence of chaplain and/or<br />
family in the room in 66% of patients and the awareness of nonprotocol<br />
prayer by patients on their own behalf in just fewer than 50% of the<br />
patients in the control group.<br />
The MANTRA Pilot study design was also unique for its “high-dose”<br />
prayer model. In the Byrd, Harris, and Aviles studies, between one and<br />
six intercessors were used for each patient, and all intercessors were<br />
Christians. In the MANTRA Pilot, every patient randomized to the prayer<br />
therapy treatment assignment had his or her name, age, and illness sent<br />
to nine congregations of intercessors, including several Christian, Jewish,<br />
and Buddhist denominations, who all prayed on each patient’s behalf.<br />
Although not statistically significant in the small pilot population studied,<br />
the absolute reduction in complication rates of standard clinical endpoints<br />
represents one of the largest apparent treatment effects reported<br />
over the four published randomized cardiology trials.<br />
AMERICAN COLLEGE OF CARDIOLOGY<br />
CONSENSUS STATEMENT<br />
The American College of Cardiology (ACC) is currently preparing a<br />
consensus statement on CAM, which includes a section on spirituality<br />
(14). This consensus document states that given the current literature, no<br />
recommendations can be made regarding the application of spiritual<br />
therapy in cardiovascular medical practice. It also recommends that for<br />
the purpose of clinical studies, spirituality must be considered an investigational<br />
therapeutic agent, like any other, and that safety and efficacy<br />
trials must be conducted with full informed consent for patients. The<br />
document recommends the development of a common nomenclature for<br />
terms and standardized measures for outcomes in terms of these trials<br />
and suggests that endpoints should go beyond morbidity and mortality<br />
to include quality of life, end-of-life care issues, and cost effectiveness.<br />
That the ACC has accepted to create such a consensus document adds<br />
validity to the need for further investigation in this area.