Impact of optimism training on atherosclerotic biomarkers in coronary artery disease: A randomized controlled trial

Abstract

Background: Atherosclerosis, a chronic inflammatory condition, is the leading cause of cardiovascular disease (CVD) morbidity and mortality worldwide. Intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) are key mediators of leukocyte-endothelial interactions and drivers of atherosclerotic progression. While optimism-based psychological interventions have demonstrated beneficial effects on several inflammatory biomarkers, their impact on adhesion molecules remains unclear. Methods: We conducted a randomized controlled trial involving 61 outpatients with stable coronary artery disease (CAD) who had completed cardiac rehabilitation. Participants were randomized to an eight-week group-based optimism training program or an attention-matched cardiac education control. Changes in plasma ICAM-1 and VCAM-1 levels were measured by ELISA at baseline and 16 weeks as well as psychological measures of depression, anxiety, and negative affect. Results: The optimism intervention significantly improved psychological outcomes, with reductions in depression, anxiety, and negative affect compared to controls (p < 0.05). While post-intervention adhesion molecule levels showed significant between-group differences, effect sizes were small and inconclusive, with no significant group-by-time interactions. Correlation analyses found no significant link between changes in optimism and adhesion molecule levels. Conclusions: Optimism-based interventions yield meaningful psychological benefits in patients with CAD, though changes in adhesion molecule biomarkers were small and uncertain. High variability in biomarker levels and limited detectable effect sizes highlight the need for larger studies to clarify the clinical significance of these findings.