NPPB and acute myocardial infarction: One study by Rydlewska found that increasing perceived control is associated with increased self-efficacy, decreased depressive symptoms, and decreased BNP.[36] In other cardiac populations, less perceived control prior to an acute coronary event predicts in-hospital complications, and after acute myocardial infarction or revascularization, level of perceived control is more predictive of psychosocial recovery than physical factors such as NYHA functional class.[32–33] The relationship between perceived control and QOL in HF is also a new area of exploration.