October 26, 2013Psychosomatic Medicine
Predictive Value of Social Inhibition and Negative Affectivity for Cardiovascular Events and Mortality in Patients With Coronary Artery Disease
Why the study?
Does the Type D personality construct (negative affectivity and social inhibition) predict cardiovascular events and mortality in patients with coronary artery disease?
Population
541 patients with coronary artery disease (CAD)
Comparison
Type D personality construct vs Patients with high NA or SI alone, or low trait…
Design
Cohort
Follow-up
5 years
Authors
Discussion
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Implication
Type D may refine CAD risk stratification; leaves open whether screening or intervention improves outcomes.
Key Points
- To determine whether adverse cardiovascular outcomes in patients with coronary artery disease stem from the combined synergy of negative affectivity and social inhibition or from either trait independently.
- Followed 541 patients with coronary artery disease over a 5-year period using the 14-item Type D Scale.
- Evaluated the Type D construct using both a continuous interaction of negative affectivity and social inhibition z scores and a dichotomous four-group classification with a cutoff score of 10.
- Tracked endpoints of major adverse cardiac events (MACE; death, myocardial infarction, revascularization) and the combined endpoint of cardiac death or myocardial infarction.
- During follow-up, 113 patients experienced MACE and 47 experienced cardiac death or myocardial infarction.
- Continuous interaction of negative affectivity and social inhibition independently predicted MACE (OR = 1.36, 95% CI = 1.11–1.67) and cardiac death/myocardial infarction (OR = 1.48, 95% CI = 1.11–1.96) after controlling for disease severity, demographics, and depressive symptoms.
- Dichotomized Type D personality was associated with an adjusted OR of 1.74 (95% CI = 1.11–2.73) for MACE and an OR of 2.35 (95% CI = 1.26–4.38) for cardiac death/myocardial infarction, whereas high levels of either trait alone conferred no increased risk.
Structured PICO
Does the Type D personality construct (negative affectivity and social inhibition) predict cardiovascular events and mortality in patients with coronary artery disease?
P
Population
541 patients with coronary artery disease (CAD)
I
Intervention
Type D personality construct (combination of negative affectivity [NA] and social inhibition [SI])
C
Comparator
Patients with high NA or SI alone, or low trait scores
O
Outcome
Major adverse cardiac events (MACEs; death, myocardial infarction [MI], coronary revascularization) and cardiac death/MI at 5-year follow-upcomposite
The Type D personality construct, characterized by the combination of negative affectivity and social inhibition, is an independent predictor of major adverse cardiac events and mortality in patients with coronary artery disease.
Cite This Study
Denollet et al. (2013) studied this question.