Zhang Youyang, Wu Shihao, Pan Jiangqi, Hoschar Sophia, Wang Zhen, Tu Rongxiang, Ladwig Karl-Heinz, Ma Wenlin
Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Geriatrics, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
J Thorac Dis. 2020 Sep;12(9):4680-4689. doi: 10.21037/jtd-20-1546.
The Type D Personality (TDP) has been specifically linked to acute myocardial infarction (AMI). However, the impact on prehospital delay of AMI patients is unclear. The aim of this study was to assess the relationship between TDP and pre-hospital delay time (PHT) in a Chinese population.
A total of 256 AMI patients (47 women and 209 men) were taken from the Multicenter Delay in Patients Experiencing AMI in Shanghai (MEDEA FAR-EAST) study. Sociodemographic and psycho-behavioral characteristics were assessed by bedside interviews and questionnaires. TDP was evaluated according to the Type D Personality Scale (DS14) subdivided in social inhibition (SI) and negative affectivity (NA). Based on a significant interaction analysis of TDP and sex on PHT, all analyses were stratified by sex.
PHT of female patients with TDP were substantially shorter compared to non-TDP female patients (108 281 min, P=0.029). In male patients, no effect of TDT on PHT was found. Spearman correlation analysis suggests that NA was negatively correlated with PHT (r=-0.358, P=0.014). Further age-adjusted logistic regression analyses showed that female patients with TDP were generally less likely to prehospital delay compared with non-TDP patients (OR =0.28; 95% CI, 0.08-0.98) and had a lower risk of PHT >360 minutes (OR =0.10; 95% CI, 0.01-0.91). However, statistical significance disappeared after adjustment for psychological factors (anxiety, depression, suboptimal wellbeing, cardiac denial and stress event).
TDP is associated with less prehospital delay in female patients during AMI-an effect which may be particularly mediated by NA.
D型人格（TDP）与急性心肌梗死（AMI）有特定关联。然而，其对AMI患者院前延迟的影响尚不清楚。本研究旨在评估中国人群中TDP与院前延迟时间（PHT）之间的关系。
共纳入256例AMI患者（47例女性，209例男性），来自上海多中心AMI患者延迟研究（MEDEA FAR-EAST）。通过床边访谈和问卷评估社会人口统计学和心理行为特征。根据分为社交抑制（SI）和消极情感（NA）的D型人格量表（DS14）评估TDP。基于TDP和性别对PHT的显著交互分析，所有分析按性别分层。
与非TDP女性患者相比，TDP女性患者的PHT显著更短（108±281分钟，P = 0.029）。在男性患者中，未发现TDT对PHT有影响。Spearman相关性分析表明，NA与PHT呈负相关（r = -0.358，P = 0.014）。进一步的年龄调整逻辑回归分析显示，与非TDP患者相比，TDP女性患者院前延迟的可能性通常较小（OR = 0.28；95%CI，0.08 - 0.98），且PHT>360分钟的风险较低（OR = 0.10；95%CI，0.01 - 0.91）。然而，在调整心理因素（焦虑、抑郁、健康欠佳、心脏否认和应激事件）后，统计学显著性消失。
TDP与AMI期间女性患者较短的院前延迟相关——这种效应可能尤其由NA介导。
