Impact of type D personality on clinical outcomes in Asian patients with stable coronary artery disease
Journal
Journal of the Formosan Medical Association
Journal Volume
118
Journal Issue
3
Pages
721-729
Date Issued
2019
Author(s)
Leu H.-B.
Yin W.-H.
Tseng W.-K.
Lin T.-H.
Yeh H.-I.
Cheng Chang K.
Wang J.-H.
Chen J.-W.
Abstract
Background: Some personality types are associated with cardiovascular (CV) diseases and may be related to clinical outcomes in coronary artery disease (CAD). This study investigates the association between type D personality and clinical outcomes in stable CAD patients in an Asian cohort. Methods: Stable CAD patients were enrolled and prospectively followed up for at least 1 year in Taiwan. The inclusion criteria were at least one successful percutaneous coronary intervention (PCI) and stable medical treatment for at least 1 month before enrollment. Vulnerability to psychological distress was measured by the Type D Personality Scale (DS14) after enrollment. The end point was the occurrence of total CV events. Cox regression models of CV events were used to investigate the role of type D personality in clinical outcomes. Results: The study included 777 patients, among which 122 (15.77%) had type D personality. Forty-two CV events were identified: 3 cardiac deaths, 5 nonfatal myocardial infarctions, 1 stroke, 4 congestive heart failures (CHF), 6 peripheral arterial occlusive disorder cases, and 23 readmissions for angina/revascularization treatment. Patients with type D personality had significantly higher incidence of future CV events (9.84% vs. 4.58%, p = 0.018%) and admission for angina/revascularization (5.74% vs. 2.44%, p = 0.049). Patients with subsequent CV events were more likely to have type D personality (28.57% vs. 14.97%, p=0.018). After proportional Cox regression analysis, type D personality remained an independent predictor of future CV events (HR: 3.21, 95% CI: 1.06–9.69). In subgroup analyses, type D personality was especially associated with higher risk of total CV events among females, the elderly, hypertension patients, diabetes patients, and non-smokers. Conclusion: Type D personality was an independent predictor of CV outcomes in an Asian cohort of stable CAD patients. This personality type may be identified in risk stratification for secondary prevention after PCI. ? 2018
SDGs
Other Subjects
acute coronary syndrome; acute heart infarction; adult; angina pectoris; Article; Asian; cardiovascular disease; cerebrovascular accident; clinical outcome; cohort analysis; congestive heart failure; coronary artery disease; diabetic patient; distress syndrome; female; follow up; heart death; heart infarction; high risk patient; hospital readmission; human; hypertensive patient; major clinical study; male; middle aged; nonsmoker; percutaneous coronary intervention; peripheral occlusive artery disease; personality assessment; prospective study; revascularization; type D behavior; Type D Personality Scale; unstable angina pectoris; aged; coronary artery disease; hypertension; mortality; procedures; register; risk factor; survival analysis; Taiwan; treatment outcome; Aged; Coronary Artery Disease; Female; Humans; Hypertension; Male; Middle Aged; Percutaneous Coronary Intervention; Prospective Studies; Registries; Risk Factors; Survival Analysis; Taiwan; Treatment Outcome; Type D Personality
Publisher
Elsevier B.V.
Type
journal article