Psychology Department of the Public Health Institute of Harbin Medical University, Harbin, China; Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Psychology Department of the Public Health Institute of Harbin Medical University, Harbin, China.
J Psychosom Res. 2020 Nov;138:110244. doi: 10.1016/j.jpsychores.2020.110244. Epub 2020 Sep 10.
Type D personality is a psychosocial risk factor for cardiovascular events and in-stent restenosis (ISR), but the mechanisms involved are not well understood. This study aimed to evaluate the effects of dietary patterns on the association between Type D personality and ISR in patients with coronary artery disease treated with percutaneous coronary intervention (PCI).
This cross-sectional study comprised a total of 230 post-PCI patients who were assessed for Type D personality, depression, dietary patterns, physical activity and medication adherence via self-administered questionnaires. ISR was assessed by coronary angiography.
Type D personality (odds ratio [OR], 3.35; 95% confidence interval [CI], 1.05-10.71, p=0.042), low fruit intake (OR, 0.30; 95% CI, 0.12-0.68, p=0.008) and low vegetable intake (OR, 0.48, 95% CI, 0.27-0.91, p=0.021) were independent risk factors for ISR after adjustment for psychosocial, lifestyle and cardiovascular risk factors. Mediation analyses revealed that Type D personality had a significant direct effect on the development of ISR (p<0.05). In addition, nutrients in fruits and vegetables, including vitamin C, vitamin E and fiber, were important mediators of the relationship between Type D personality and ISR (p<0.05), the percentage of total indirect effect was 24.65%.
These findings suggested that the low intake of fruit and vegetables in Type D patients can predict ISR. The healthy dietary interventions to supply vitamin C, vitamin E and fiber may help to improve the prognosis in post-PCI patients with Type D personality.
D 型人格是心血管事件和支架内再狭窄（ISR）的心理社会危险因素，但相关机制尚不清楚。本研究旨在评估饮食模式对经皮冠状动脉介入治疗（PCI）后冠心病患者 D 型人格与 ISR 之间关系的影响。
本横断面研究共纳入 230 例 PCI 后患者，通过自我管理问卷评估 D 型人格、抑郁、饮食模式、身体活动和药物依从性。通过冠状动脉造影评估 ISR。
D 型人格（比值比[OR]，3.35；95%置信区间[CI]，1.05-10.71，p=0.042）、低水果摄入（OR，0.30；95%CI，0.12-0.68，p=0.008）和低蔬菜摄入（OR，0.48，95%CI，0.27-0.91，p=0.021）是调整心理社会、生活方式和心血管危险因素后 ISR 的独立危险因素。中介分析显示，D 型人格对 ISR 的发生有显著直接影响（p<0.05）。此外，水果和蔬菜中的营养素，包括维生素 C、维生素 E 和纤维，是 D 型人格与 ISR 之间关系的重要中介（p<0.05），总间接效应的百分比为 24.65%。
这些发现表明，D 型人格患者水果和蔬菜摄入量低可预测 ISR。通过健康饮食干预补充维生素 C、维生素 E 和纤维可能有助于改善 D 型人格 PCI 后患者的预后。
