Type D personality, cardiovascular risk factors and risk of recurrent major adverse cardiac events in outpatients with coronary heart disease

Autor: KS Torgersen, E Sverre, H Weedon-Fekjaer, OA Andreassen, J Munkhaugen, T Dammen
Rok vydání: 2022
Předmět:
Zdroj: European Journal of Preventive Cardiology. 29
ISSN: 2047-4881
2047-4873
DOI: 10.1093/eurjpc/zwac056.110
Popis: Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Kristin S. Torgersen received founding from the University of Oslo, Research Council of Norway. Introduction The mechanisms linking type D personality to cardiac prognosis in terms of major adverse cardiac events (MACE) and the association between Type D and MACE after controlling for symptoms of anxiety and depression is largely unknown. Propose To investigate the relationship between Type D personality and the Type D characteristics of negative affectivity (NA) and social inhibition (SI) and i) cardiovascular risk factors and ii) risk of recurrent MACE in CHD outpatients. Methods This prospective multicenter cohort study included 1083 patients 2-36 (mean 16) months after a myocardial infarction and/or a revascularization procedure. At baseline, patients underwent a clinical examination and answered a questionnaire including assessment of Type D personality (DS14), anxiety and depression (Hospital Anxiety and Depression Scale (HADS), medication adherence and risk factors (hypertension, smoking, diabetes, low physical activity, waist circumference, low-density lipoprotein cholesterol and C-reactive Protein). The primary composite endpoint of MACE defined as cardiovascular death, hospitalization for myocardial infarction, revascularization, stroke/transitory ischemic attacks or heart failure were obtained from hospital records on average 4.2 (SD 0.4) years after baseline. Data were analyzed by Cox proportional hazard regression stratified for prior coronary events. Results The prevalence of Type D was 18% at baseline. Type D patients were younger at the index event (59.3 vs 62.1 years, p= 0.001), more likely to be female (26.4 vs 19.8 %, p=0.038), scored higher on HADS anxiety (8.4 vs 3.9, p < 0.001), HADS depression (3.2 vs 7.0, p Conclusions Type D personality was only associated with low medication adherence and smoking which may represent potential mechanisms linking type D to cardiovascular prognosis. In our study, only negative affectivity was associated with MACE, suggesting that this is the most important type D characteristic for prognosis. However, NA was no longer associated with MACE after adjusting for anxiety and depression raising the question whether NA, depression and anxiety may have common underlying factors or are overlapping constructs.
Databáze: OpenAIRE