Torgersen Kristin Stensland, Sverre Elise Christine Bjørkholen, Weedon-Fekjær Harald, Andreassen Ole A, Munkhaugen John, Dammen Toril
Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Front Psychol. 2023 Mar 28;14:1119146. doi: 10.3389/fpsyg.2023.1119146. eCollection 2023.
Data on the association between Type D personality, its traits negative affectivity (NA) and social inhibition (SI), and risk of major adverse cardiac events (MACE) in coronary outpatients is sparse. Furthermore, the associations between Type D subgroups and cardiovascular risk factors are largely unknown.
We investigated i) Type D personality, NA and SI and risk of recurrent MACE, and ii) the relationship between Type D subgroups and risk factors in a coronary population. This prospective cohort study included 1083 patients` median 16 months after a myocardial infarction and/or a revascularization procedure who were followed-up for 4.2 (SD 0.4) years. Type D personality was assessed by DS14. Anxiety and depression, statin adherence, and risk factors were assessed by patients' self-report and a clinical examination with blood samples. MACE, defined as cardiovascular death, myocardial infarction, revascularization, stroke or heart failure, were obtained from hospital records from index event to end of study lasting 5.7 years. Data were analyzed by Cox proportional hazard regression.
In all, 352 MACE occurred in 230 patients after average 4.2 years follow-up. Higher NA score was associated with MACE after adjustment for age, risk factors and comorbidity (HR 1.02 per unit increase, 95% CI 1.00-1.05), whereas we found a weaker, not statistically significant estimated effect of higher SI score. After additional adjustment for symptoms of anxiety and depression, we found a weaker, not statistically significant association between NA and MACE (HR 1.01 per unit increase, 95% CI 0.98-1.05). Low statin adherence and smoking were more prevalent in the Type D and high NA group.
Our results indicate that the NA trait is related to worse prognosis in outpatients with coronary artery disease.
关于D型人格及其特质消极情感（NA）和社交抑制（SI）与冠心病门诊患者主要不良心脏事件（MACE）风险之间关联的数据较为稀少。此外，D型人格亚组与心血管危险因素之间的关联在很大程度上尚不清楚。
我们在冠心病患者群体中研究了：i）D型人格、NA和SI与复发性MACE风险之间的关系，以及ii）D型人格亚组与危险因素之间的关系。这项前瞻性队列研究纳入了1083例患者，这些患者在心肌梗死和/或血管重建术后中位数16个月，随访时间为4.2（标准差0.4）年。通过DS14评估D型人格。通过患者自我报告和临床血液样本检查评估焦虑和抑郁、他汀类药物依从性以及危险因素。MACE定义为心血管死亡、心肌梗死、血管重建、中风或心力衰竭，数据来自从索引事件到持续5.7年的研究结束的医院记录。采用Cox比例风险回归分析数据。
在平均4.2年的随访后，230例患者共发生352次MACE。在对年龄、危险因素和合并症进行调整后，较高的NA得分与MACE相关（每单位增加的风险比为1.02，95%置信区间为1.00 - 1.05），而较高的SI得分的估计效应较弱，无统计学意义。在对焦虑和抑郁症状进行额外调整后，我们发现NA与MACE之间的关联较弱，无统计学意义（每单位增加的风险比为1.01，95%置信区间为0.98 - 1.05）。D型人格和高NA组中他汀类药物依从性低和吸烟更为普遍。
我们的结果表明，NA特质与冠心病门诊患者的预后较差有关。
