Key result
The combination of Type D personality and depression in patients with acute myocardial infarction was associated with a higher risk of major adverse cardiac events (95% CI 1.74-6.07).
Why the study?
Type D personality and depression independently predict adverse cardiovascular outcomes, but their combined effect on clinical outcomes in patients with AMI required examination.
Does the combination of Type D personality and depression increase the risk of adverse cardiovascular events in patients with acute myocardial infarction?
Cohort (n=3,568)
Does the combination of Type D personality and depression increase the risk of adverse cardiovascular events in patients with acute myocardial infarction?
The combination of Type D personality and depression significantly increases the risk of MACE and in-stent restenosis after acute myocardial infarction, highlighting the importance of psychological assessment in these patients.
May inform post-AMI risk stratification; hypothesis-generating for whether interventions targeting Type D personality and depression reduce events.
BACKGROUND: Type D personality and depression are the independent psychological risk factors for adverse outcomes in cardiovascular patients. The aim of this study was to examine the combined effect of Type D personality and depression on clinical outcomes in patients suffering from acute myocardial infarction (AMI). METHODS: This prospective cohort study included 3568 patients diagnosed with AMI between February 2017 and September 2018. Type D personality and depression were assessed at baseline, while the major adverse cardiac event (MACE) rate (cardiac death, recurrent non-fatal myocardial infarction, revascularization, and stroke) and in-stent restenosis (ISR) rate were analyzed after a 2-year follow-up period. RESULTS: A total of 437 patients developed MACEs and 185 had ISR during the follow-up period. The Type D (+) depression (+) and Type D (+) depression (-) groups had a higher risk of MACE [95% confidence interval (CI) 1.74-6.07] (95% CI 1.25-2.96) and ISR (95% CI 3.09-8.28) (95% CI 1.85-6.22). Analysis of Type D and depression as continuous variables indicated that the main effect of Type D, depression and their combined effect were significantly associated with MACE and ISR. Moreover, Type D (+) depression (+) and Type D (+) depression (-) emerged as significant risk factors for MACE and ISR in males, while only Type D (+) depression (+) was associated with MACE and ISR in female patients. CONCLUSIONS: These findings suggest that patients complicated with depression and Type D personality are at a higher risk of adverse cardiovascular outcomes. Individual assessments of Type D personality and depression, and comprehensive interventions are required.
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Wang et al. (2021) conducted a cohort in acute myocardial infarction (AMI) (n=3,568). Type D personality and depression vs. Absence of Type D personality and/or depression was evaluated on major adverse cardiac event (MACE) (cardiac death, recurrent non-fatal myocardial infarction, revascularization, and stroke) (95% CI 1.74-6.07). The combination of Type D personality and depression in patients with acute myocardial infarction was associated with a higher risk of major adverse cardiac events (95% CI 1.74-6.07).
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