STRESS MANAGEMENT ON THE INCIDENCE OF MAJOR CARDIOVASCULAR EVENTS: PROTOCOL OF A SYSTEMATIC REVIEW

Abstract

This is a Systematic review of randomized controlled trials to To evaluate the effect of psychological interventions for stress management on the incidence of major adverse cardiovascular events in individuals with coronary artery diasease. The primary outcome will be a combination of major adverse cardiovascular events endpoints including cardiovascular death, nonfatal acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft surgery, nonfatal stroke, and cardiovascular hospitalization. Outcomes will be presented as Risk Ratio (RR) and related 95% confidence intervals (95% CIs). Data will be pooled using a random-effects model to account for clinical heterogeneity in psychological interventions. Heterogeneity of results will be tested using the Higgins inconsistency test (I²). Univariate meta-regression will be used to assess heterogeneity of studies and the level of significance will be set at p <0.05. We will use Cochrane Risk of Bias 2 (RoB 2) tool to assess the risk of individual bias and GRADE tool to evaluate the quality of individual studies in the systematic review. Statistical analyses will be performed using RStudio for Windows (v1.3.959).  The protocol of this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42021275198)