Brief Internet-delivered CBT After ACS

The purpose of the present pilot study is to evaluate the feasibility and potential efficacy of a brief, internet-delivered CBT protocol provided early after acute coronary syndrome (ACS).

Inclusion Criteria:(A) ACS ≥ four weeks to six months before assessment (MI type 1 STEMI/NSTEMI and UA)(B) Age 18-80 years(C) Symptoms of PTSD and/or cardiac anxiety that leads to distress and/or interferes with daily life (PCL5; ≥ 10, CAQ: ≥20)(D) On standard of care medical treatment for the cardiac condition according to Swedish cardiovascular guidelines(E) Ability to read and write in Swedish.Exclusion Criteria:(F) Heart failure with severe systolic dysfunction (ejection fraction ≤ 35%)(G) Significant valvular disease(H) Planned coronary artery bypass surgery or percutaneous interventions(I) Any medical restriction to physical exercise(J) Severe uncontrolled medical illness i.e., advanced cancer(K) Grade 3 hypertension (i.e., blood pressure ≥ 180 systolic and/or 110 diastolic)(L) Severe psychiatric disorder, active suicidal ideations or cognitive impairment that precludes provision of informed consent or study activities(M) Alcohol dependency(N) Ongoing psychological treatment.