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Original research
Effects of music therapy on anxiety and physiologic parameters in angiography: a systematic review and meta-analysis
  1. Adam C Lieber1,
  2. Javin Bose1,
  3. Xiangnan Zhang1,
  4. Hayley Seltzberg1,
  5. Joanne Loewy2,
  6. Andrew Rossetti2,
  7. J Mocco1,
  8. Christopher P Kellner1
  1. 1 Department of Neurosurgery, Mount Sinai Hospital, New York, USA
  2. 2 The Louis Armstrong Center for Music and Medicine, New York, USA
  1. Correspondence to Mr. Adam C Lieber, Department of Neurosurgery, Mount Sinai Hospital, New York, NY 10029, USA; adam.lieber{at}


Background Given the anxiety patients experience during angiography, evidence supporting the efficacy of music therapy during these angiographic procedures is potentially of clinical value.

Objective To analyze the existing literature forthe use of music therapy during cerebral, coronary, and peripheral angiography to determine whether it improves patient anxiety levels, heart rate, and blood pressure during the procedure.

Methods PubMed, Embase, and Scopus were searched to identify studies of interest. Inclusion criteria included studies reporting using music therapy in either cerebral, coronary, or peripheral angiography. Studies focused on a pediatric population; animal studies and case reports were excluded. Participant demographics, interventions, and outcomes were collected by two study authors. Bias and study quality of randomized controlled trials (RCTs) were assessed using the Cochrane Risk of Bias Tool. Separate meta-analyses of the RCTs were performed to compare State Trait Anxiety Inventory (STAI), heart rate (HR), and systolic and diastolic blood pressure (SBP and DBP) in the music intervention group versus control group. Heterogeneity was determined by calculating I2 values, and a random-effects model was used when heterogeneity exceeded 50%.

Results The preprocedure to postprocedure improvement in STAI was significantly greater in the experimental group than the control group (p=0.004), while the decrease in HR, SBP, and DBP was not significant.

Conclusions Recorded music and/or music therapy in angiography significantly decreases patients’ anxiety levels, while it has little to no effect on HR and BP. This meta-analysis is limited by the relatively few RCTs published on this subject.

PROSPERO registration number CRD42018099103

  • angiography
  • blood pressure
  • catheter
  • blood flow

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  • Contributors The authors have all contributed significantly to the composition of the manuscript and critically edited the final version for content. All have agreed to the presented order of authorship.

  • Funding This research was supported in part by a grant from Arminio and Lucyna Fraga and by a grant from Mr and Mrs Durkovic.

  • Competing interests CPK: (1) director of CME course titled ’Endoscopic minimally invasive intracerebral hemorrhage evacuation' funded by Penumbra and (2) recipient of a Siemens Foundation research grant. JB: son of Arani Bose, MD, Chief Medical Officer and Chairman of Penumbra, Inc. JM: National/International PI/Co-PI: INVEST (Co-PI), COMPASS (Co-PI), THERAPY (PI), FEAT (PI), POSITIVE (Co-PI), BARREL (PI); consultant: TSP, Rebound Therapeutics, Viseon, Pulsar, Cerebrotech, Endostream, Vastrax; Investor/Stockholder/Owner: Cerebrotech, TSP, Endostream, Apama, Rebound, Viseon, Neurvana, Cardinal Consulting, BlinkTBI, Serenity, NTI.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Presented at This work has not been previously presented at a conference nor published as a conference abstract.