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Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease
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| Background: Type D personality (high negative affectivity and social inhibition) is associated with cardiovascular events and coronary plaque severity. Whether Type D is also related to functional vasomotion abnormalities is unknown. We examined concurrent and predictive associations of Type D with endothelial dysfunction in patients with coronary artery disease (CAD). Methods: At baseline, 180 CAD patients (90% men; M= 58.0 years) completed Type D (DS14) and depression scales, and entered a 12-week exercise program. Flow-mediated dilation (FMD) of the brachial artery and circulating CD34(+)/KDR+/CD45(+) dim endothelial progenitor cells (EPCs) were assessed at baseline, 3 months, and 12 months. Logistic regression and linear mixed models were used to analyze endothelial function. Results: Type D personality was associated with decreased FMD across baseline, 3 months, and 12 months (mixed model analysis, p=0.04), after adjustment for clinical characteristics, exercise training and depression. There was no significant association between Type D and decreased EPCs (p=0.07). Age and smoking were other significant correlates of FMD and EPCs. Using a FMD < 5.5% cut-off, Type D patients more often had endothelial dysfunction at baseline (24/37 = 65%) than non-Type Ds (63/143 = 44%); OR = 3.03, 95% CI 1.04-8.80. This significant Type D effect was confirmed in prospective analyses of endothelial dysfunction at 12 months (OR=3.43, 95% CI 1.01-11.64), and in subgroup analyses of male patients. Conclusions: Type D personality was associated with impaired endothelial function in men with CAD. This association was robust across time, independent fromdepressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD. (c) 2018 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license |
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English
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International journal of cardiology. - Amsterdam, 1981, currens | |
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Amsterdam : 2018
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0167-5273
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259(2018), p. 205-210
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000428300900048
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29477262
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