Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark.
Department of Cardiovascular Epidemiology and Research, The Danish Heart Foundation, Copenhagen, Denmark.
Qual Life Res. 2019 Nov;28(11):2901-2908. doi: 10.1007/s11136-019-02241-6. Epub 2019 Jul 10.
The "distressed" (Type D) personality trait has been reported to be over-represented in patients with heart failure (HF) compared to the background population and may provide prognostic information for mortality. We examined the association between Type D personality and outcomes in the DANISH trial (The Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators in Patients with Non-ischemic Systolic Heart Failure on Mortality).
The DANISH trial included a total of 1116 patients with non-ischemic HF on guideline-recommended therapy. Type D personality was assessed with the Type D Scale (DS14) at baseline and investigated through follow-up accordingly. Multivariable Cox proportional hazard models were used to compare hazard ratios (HR) of cardiovascular and all-cause mortality.
Type D personality assessment was completed by 873 (78%) patients at baseline and Type D personality was found in 120 (14%) patients. The median follow-up was 67 months (interquartile range [IQR] 48-83). Among patients with versus without Type D personality, 22% versus 19% died from all-cause yielding similar incidence rates of 4.62 (95% CI 3.14-6.87) versus 3.95 (95% CI 3.37-4.66) per 100 person-years. The adjusted risk of all-cause mortality was not significantly different in patients with versus without Type D personality with an adjusted HR of 1.31 (95% CI 0.84-2.03, p = 0.23) with similar results for cardiovascular death (HR 1.46 (95% CI 0.88-2.44, p = 0.15).
Type D personality was not significantly associated with increased risk of all-cause mortality or cardiovascular death in patients with non-ischemic HF.
与背景人群相比，心力衰竭（HF）患者中“苦恼”（Type D）人格特质的比例过高，并且可能为死亡率提供预后信息。我们研究了 Type D 人格特质与 DANISH 试验（丹麦评估非缺血性收缩性心力衰竭患者植入式心脏复律除颤器疗效的研究）结局之间的关系。
DANISH 试验共纳入 1116 名接受指南推荐治疗的非缺血性 HF 患者。在基线时使用 Type D 量表（DS14）评估 Type D 人格特质，并进行相应的随访。多变量 Cox 比例风险模型用于比较心血管和全因死亡率的危险比（HR）。
在基线时有 873 名（78%）患者完成了 Type D 人格特质评估，其中 120 名（14%）患者存在 Type D 人格特质。中位随访时间为 67 个月（四分位间距 [IQR] 48-83）。在存在与不存在 Type D 人格特质的患者中，分别有 22%和 19%的患者因全因死亡，全因死亡率的发生率分别为 4.62（95%CI 3.14-6.87）和 3.95（95%CI 3.37-4.66）/100 人年。存在与不存在 Type D 人格特质的患者全因死亡的调整风险无显著差异，调整 HR 为 1.31（95%CI 0.84-2.03，p=0.23），心血管死亡的结果相似（HR 1.46（95%CI 0.88-2.44，p=0.15）。
在非缺血性 HF 患者中，Type D 人格特质与全因死亡率或心血管死亡率的增加无显著相关性。
