Acute myocardial infarction (heart attack) remains a major cause of cardiovascular mortality, and percutaneous coronary intervention (PCI) is a standard treatment for restoring coronary blood flow. Anxiety and depression after heart attack are associated with poorer cardiovascular prognosis, suggesting that stress-reduction interventions may have value as adjuncts to standard cardiac care. Mindfulness-Based Stress Reduction (MBSR) has shown some promise for improving emotional well-being in cardiac patients.

Xiong et al. [Scientific Reports] conducted a prospective matched-control pilot study to examine whether MBSR might improve recovery in heart attack patients through changes in systemic inflammation, cardiac function, functional capacity, and DNA methylation. The study included 51 male patients who had undergone PCI and were clinically stable one month after the procedure. Seventeen patients chose to participate in an 8-week MBSR program plus standard medical therapy, and 34 matched patients served as controls receiving standard therapy alone. The study was not randomized. All eligible female patients either declined or withdrew from the MBSR program, resulting in an all-male sample.

The MBSR intervention followed a standardized 8-week format with weekly 2- to 2.5-hour group sessions led by a certified instructor. Sessions included body scanning, mindful breathing, gentle yoga, and guided discussion of stress perception and management. Participants were also instructed to complete 30 minutes of audio-guided mindfulness practice at home each day. Outcomes were assessed at baseline and at 6-month follow-up and included inflammatory biomarkers, echocardiographic measures of cardiac structure and function, and the 6-minute walk test. A randomly selected subgroup of 5 MBSR participants and 5 controls also underwent genome-wide DNA methylation profiling using reduced representation bisulfite sequencing.

The clinical results favored the MBSR group. At 6 months, MBSR participants showed significantly greater reductions in C-reactive protein, interleukin-6, and procalcitonin than controls, with effects remaining significant after adjustment for baseline values and GP IIb/IIIa inhibitor use and after false discovery rate correction. Cardiac and functional outcomes also improved. Compared with controls, the MBSR group had better left ventricular ejection fraction, global longitudinal strain, wall motion score index, interventricular septal thickness, and 6-minute walk distance at follow-up after adjusted analyses and false discovery rate correction. Six-minute walk distance improved in both groups, but the gain was larger in the MBSR group.

The molecular findings were exploratory. MBSR was associated with thousands of nominally differentially methylated sites and regions, and these changes were mapped to pathways related to immune response, inflammation, oxidative stress, coagulation, cardiac remodeling, and neuroendocrine stress regulation. However, after strict genome-wide correction, no differentially methylated sites or regions remained statistically significant.

This study suggests that MBSR may be a promising adjunctive intervention for post-PCI recovery in people with heart attack. The study is notable for linking mindfulness practice to objective cardiovascular and molecular outcomes rather than relying only on self-reported psychological measures, yet the mechanistic claims should be interpreted cautiously. The study was non-randomized, small, all male, and included only ten participants in the methylation substudy.

Reference

Xiong, M., Dou, X., Tao, J., Hu, F., Jing, P., Zhao, Z., Cai, H., Hu, Z., & Zhang, M. (2026). DNA methylation mediates MBSR induced cardioprotection in patients after PCI. Scientific Reports. [link]