Tópico: Reza à distância não melhora angioplastia coronariana

[Stéfano]

Distant Prayer May Not Improve Outcome of Elective Percutaneous Coronary Interventions

News Author: Laurie Barclay, MD

July 18, 2005 — Distant prayer does not improve outcome of elective percutaneous coronary interventions (PCIs), according to the results of a randomized study published in the July 16 issue of The Lancet.

"If we want to understand the role of human capacities and resources in the midst of our most advanced medical technologies, we have to do good science," lead author Mitchell W. Krucoff, MD, FACC, FCCP, from the Duke Clinical Research Institute in Durham, North Carolina, said in a news release. "With no notion of the actual mechanisms involved in ancient healing practices such as prayer or touch or music, structured outcomes research allows us to collect data that we can learn from in many ways."

The Monitoring and Actualisation of Noetic Trainings (MANTRA) II was a U.S. multicenter, prospective trial comparing the effects of intercessory prayer with those of music, imagery, and touch (MIT) therapy in patients undergoing coronary procedures. In a 2×2 factorial design, 748 patients undergoing PCI or elective catheterization were randomized to either off-site prayer by established congregations of various religions or to no off-site prayer (double-blinded) and to MIT therapy or none (unmasked).

The main outcome measure was combined in-hospital major adverse cardiovascular events and six-month readmission or death; secondary outcomes were six-month major adverse cardiovascular events, death or readmission by six months, and six-month mortality. For the primary composite endpoint, there was no significant difference for any treatment comparison. However, six-month mortality was lower with MIT therapy than with no MIT therapy (hazard ratio , 0.35; 95% confidence interval, 0.15 - 0.82; P = .016).

"Although the primary endpoints in this study showed no definitive treatment effects, secondary analyses can be useful for hypothesis generation to guide future trials," Dr. Krucoff said.

Issues unresolved by this study include potentially differential effects of the timing and duration of prayer, the number of intercessors praying, prayers from individuals vs those from congregations, and prayers from different religions.

"The investigation of prayer in all studies, including MANTRA II, also presents the challenge of studying only incremental effects, because many would have considered a request to patients or families not to pray for loved ones with heart disease unethical," the authors write. "Off-protocol prayer in the study population could have important effects on the study power."

The RAMA Foundation, Bakken Family Foundation, George Family Foundation, FACT Foundation, Duke University Heart Center, Duke Clinical Research Institute, Columbia University Medical Center, Geisinger Medical Center, Scripps Clinic, and the Institute of Noetic Sciences supported this study. The authors report no conflict of interest.

An accompanying editorial in The Lancet notes the extraordinary difficulties encountered in attempting to investigate noetic therapies that are intangible in that they do not involve a drug or device.

"Do the results of the MANTRA II study rule out the use of noetic therapies in modern scientific medicine? Such a conclusion would be premature," the editorialist writes. "The contribution that hope and belief make to a personal understanding of illness cannot be dismissed so lightly. They are proper subjects for science, even while transcending its known bounds."

Lancet. 2005;366:178, 211-217

[Atheist]

Que pena!