High negativity combined with high social inhibition increased the risk of MACE following PCI compared to high negativity with low inhibition (HR 1.92; 95% CI 1.22-3.01; P=0.005).
Cohort (n=875)
No
Does social inhibition modulate the effect of negative emotions on MACE in patients following PCI?
The interaction of social inhibition and negative emotions, rather than negative emotions alone, independently predicts poor clinical outcomes following PCI.
Hazard Ratio: 1.92 (95% CI 1.22–3.01)
Absolute Event Rate: 15% vs 10%
p-value: p=0.005
AIMS: Negative emotions have an adverse effect on cardiac prognosis. We investigated whether social inhibition (inhibited self-expression in social interaction) modulates the effect of negative emotions on clinical outcome following percutaneous coronary intervention (PCI). METHODS AND RESULTS: Eight hundred and seventy-five consecutive patients from the RESEARCH registry (Erasmus Medical Centre, Rotterdam) completed depression, anxiety, negativity (negative emotions in general), and social inhibition scales 6 months following PCI. The endpoint was major adverse cardiac event (MACE-death, myocardial infarction, coronary artery bypass graft (CABG), or PCI) at 9 months following assessment. There were 100 MACE; patients who were high in both negativity and inhibition were at increased risk of MACE (38/254=15%) when compared with high negativity/low inhibition patients (13/136=10%; P=0.018). Depression (P=0.23) or anxiety (P=0.63) did not explain away this moderating effect of inhibition. High negativity/high inhibition (HR=1.92, 95%CI 1.22-3.01, P=0.005) and previous CABG (HR=1.90, 95%CI 1.04-3.47, P=0.038) were independent predictors of MACE. Patients with high negativity but low inhibition were not at increased risk (P=0.76). High negativity/high inhibition also independently predicted death/MI (n=20) as a more specific endpoint (HR=5.85, P=0.001). CONCLUSION: The interaction effect of social inhibition and negative emotions, rather than negative emotions per se, predicted poor clinical outcome following PCI. Social inhibition should not be overlooked as a modulating factor.
Denollet et al. (Mon,) conducted a cohort in percutaneous coronary intervention (PCI) (n=875). High negativity and high social inhibition vs. High negativity and low social inhibition was evaluated on major adverse cardiac event (MACE-death, myocardial infarction, coronary artery bypass graft (CABG), or PCI) (HR 1.92, 95% CI 1.22-3.01, p=0.005). High negativity combined with high social inhibition increased the risk of MACE following PCI compared to high negativity with low inhibition (HR 1.92; 95% CI 1.22-3.01; P=0.005).