Anxiety disorders following percutaneous coronary intervention for acute myocardial infarction: A comprehensive review of clinical manifestations and interventions

Table 2 Psychological interventions for anxiety after percutaneous coronary intervention and their effects/applications in cardiac patients

Sources	Intervention types	Primary targets	Response patterns	Roles/functions	Potential applications
Intervention-based approaches
Psycho-cardiology	Cognitive therapy	Catastrophic interpretations	Increased (moderate)	Correct misattribution of normal post-PCI sensations	Treatment of acute anxiety
	Exposure therapy	Cardiac-related avoidance behaviors	Increased (moderate)	Rebuild self-efficacy and functional capacity	Long-term rehabilitation
	Relaxation training	Autonomic arousal	Increased (moderate)	Reduce physiological markers of anxiety	Acute phase management
	Psychoeducation	Knowledge deficits	Increased (moderate)	Increase understanding of normal recovery process	Prevention of anxiety development
Environmental approaches	A-FLORA-ACS Protocol	Hospital environment	Increased (moderate)/increased (moderate)	Provide positive attentional focus during recovery	Adjunctive treatment
	Sound therapy	Stress hormones	Increased (moderate)	Reduce autonomic arousal and improve sleep quality	Inpatient management
	Guided imagery	Rumination	Increased (moderate)	Redirect attention from cardiac concerns	Self-management tool
Cardiac rehabilitation	Supervised exercise	Physical deconditioning	Increased (moderate)	Counter avoidance behaviors through graded exposure	Comprehensive recovery
	Group-based programs	Social isolation	Increased (moderate)	Normalize experiences through peer support	Cost-effective delivery
	Stress management	Global anxiety	Increased (moderate)	Develop coping strategies for cardiac stressors	Prevention of major adverse cardiovascular event
Domains of anxiety
Physiological anxiety	Biofeedback	Heart rate variability	Increased (moderate)	Improve autonomic regulation	Targeted intervention
	Progressive muscle relaxation	Somatic tension	Increased (moderate)	Reduce physical manifestations of anxiety	Self-management
Cognitive anxiety	CBT protocols	Worry and rumination	Increased (moderate)	Restructure cardiac-related cognitions	Chronic anxiety treatment
	Mindfulness-based interventions	Attentional bias	Increased (moderate)	Develop nonjudgmental awareness of sensations	Therapeutic target
Behavioral anxiety	Activity scheduling	Activity avoidance	Increased (moderate)	Gradual reintroduction of avoided activities	Functional improvement
	Motivational interviewing	Treatment adherence	Increased (moderate)	Enhance engagement with recovery behaviors	Medication adherence
Cardiac-specific anxiety	Heart-focused anxiety treatment	Cardiac vigilance	Increased (moderate)	Reduce hypervigilance to bodily sensations	Specialized protocol
	Cardiorespiratory fitness training	Exercise anxiety	Increased (moderate)	Build confidence in cardiac capacity	Physiological improvement
Special populations
Gender-specific	Women's recovery programs	Caregiving concerns	Increased (moderate)	Address role disruption and dependency fears	Gender-focused care
	Men's cardiac groups	Autonomy threats	Increased (moderate)	Address occupational and self-efficacy concerns	Engagement enhancement
Comorbid depression	Integrated treatment protocols	Anhedonia and anxiety	Increased (moderate)	Target overlapping neurobiological mechanisms	Dual-diagnosis approach
	Behavioral activation	Withdrawal behaviors	Increased (moderate)	Increase positive reinforcement	Treatment resistance
Older adults	Age-adapted protocols	Memory and learning	Increased (moderate)	Accommodate cognitive changes in older patients	Geriatric cardiology
	Social prescribing	Isolation	Increased (moderate)	Connect patients with community resources	Sustainable support

PCI: Percutaneous coronary intervention; CBT: Cognitive behavioral therapy.