(PS5-B30) Remotely-delivered Mindfulness-based Cognitive Therapy for SCAD Survivors: Preliminary Findings of an Open Pilot Trial

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized etiology of acute coronary syndromes, particularly among young women. Approximately half of SCAD survivors struggle with fear of recurrence (FOR), which contributes to poor sleep and physical inactivity. We adapted Mindfulness-Based Cognitive Therapy (UpBeat-MBCT) to target FOR, sleep, and physical activity in SCAD survivors. The aim is to explore preliminary feasibility and acceptability from the first intervention cohort of an open pilot trial. Nine participants were enrolled (100% female, 100% white, average age=52). UpBeat-MBCT consisted of eight weekly 1.5-hour sessions via group videoconference, combining cognitive-behavioral therapy, mindfulness meditation, and health behavior promotion. Participants completed baseline and post-intervention surveys; actigraphy and daily diaries for 7 days before and after the intervention; and exit interviews. Feasibility outcomes included enrollment; data collection; attendance (i.e., > 6/8 sessions); and study retention (i.e., completion of post-intervention data collection). Acceptability outcomes included program satisfaction (1=not at all satisfied; 10=very satisfied) and exit interview themes. Enrollment was completed from 10/2021-11/2021. At baseline, 100% (9/9) of participants completed the survey and actigraphy; 44% (4/9) completed the daily diaries. One-third (3/9) completed the intervention. 44% (4/9) were retained post-intervention: 33% (3/9) completed the survey, 44% (4/9) completed actigraphy, and 11% (1/9) completed the daily diaries. Among intervention completers, program satisfaction was Mean=9.0 (SD=1.4), and 100% (3/3) would recommend the program to others. Exit interview themes revealed valuing social connection with other SCAD survivors, decreased anxiety about recurrence and physical symptoms, and improved sleep. However, participants expressed difficulty hearing others’ emotional stories about SCAD. While we found positive intervention effects among treatment completers, refinements are needed to promote retention and align the intervention with the unique needs of SCAD survivors. Possible adaptations include setting boundaries for sharing about personal experiences with SCAD, and reducing intervention dose and daily diary schedule.