Coronary artery disease (CAD) is influenced not only by biological factors but also by psychological factors. Individuals with a family history of heart disease are particularly vulnerable to elevated cardiac anxiety and reduced psychological flexibility. The present study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on cardiac anxiety and psychological flexibility in patients with coronary artery disease and a family history of heart disease. This study employed a quasi-experimental design with a pretest–posttest control group. The statistical population consisted of patients with coronary artery disease and a family history of heart disease who were referred to Imam Hossein Hospital in 2025. Thirty eligible participants were selected using convenience sampling and randomly assigned to either an intervention group (n = 15) or a control group (n = 15). The intervention group received eight sessions of Acceptance and Commitment Therapy, whereas the control group received no psychological intervention. Data were collected using the Cardiac Anxiety Questionnaire (CAQ) and the Acceptance and Action Questionnaire-II (AAQ-II). Data were analyzed using repeated-measures analysis of variance. The findings indicated that Acceptance and Commitment Therapy significantly reduced cardiac anxiety and significantly improved psychological flexibility in the intervention group compared with the control group (P < .001). Furthermore, the treatment effects were maintained at the follow-up assessment. The findings suggest that Acceptance and Commitment Therapy can be considered an effective complementary psychological intervention alongside routine medical care for reducing cardiac anxiety and enhancing psychological flexibility in patients with coronary artery disease and a family history of heart disease.
