Key result
Type D personality was associated with a significantly higher risk of total cardiovascular events compared to those without it (9.84% vs. 4.58%; HR 3.21, 95% CI 1.06-9.69).
Why the study?
Does type D personality predict cardiovascular events in stable CAD patients after PCI?
Cohort (n=777)
Does type D personality predict cardiovascular events in stable CAD patients after PCI?
Hazard Ratio: 3.21 (95% CI 1.06–9.69)
Absolute Event Rate: 9.84% vs 4.58%
p-value: p=0.018
Type D personality is an independent predictor of adverse cardiovascular outcomes in Asian patients with stable CAD after PCI, suggesting its potential utility in risk stratification.
May support type D assessment for post-PCI risk stratification; extends evidence to Asian CAD but remains hypothesis-generating.
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.
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Leu et al. (2018) conducted a cohort in stable coronary artery disease (n=777). Type D personality vs. Without type D personality was evaluated on total CV events (HR 3.21, 95% CI 1.06-9.69, p=0.018). Type D personality was associated with a significantly higher risk of total cardiovascular events compared to those without it (9.84% vs. 4.58%; HR 3.21, 95% CI 1.06-9.69).
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