Impaired health status, psychological distress, and personality in women and men with nonobstructive coronary artery disease: Sex and gender differences: The TWIST (Tweesteden Mild Stenosis Study)

P.M.C. Mommersteeg, Lindy Arts, W.P. Zijlstra, J.W.C.M. Widdershoven, W. Aarnoudse, J. Denollet

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Abstract

Background
Patients with nonobstructive coronary artery disease (NOCAD; wall irregularities, stenosis <60%), and women with NOCAD in particular, remain underinvestigated. We examined sex and gender (S&G) differences in health status, psychological distress, and personality between patients with NOCAD and the general population, as well as S&G differences within the NOCAD population.Methods and 
Results
In total, 523 patients with NOCAD (61±9 years, 52% women) were included via coronary angiography and computed tomography as part of the TWIST (Tweesteden Mild Stenosis) study. Generic health status (12-item Short Form physical and mental scales and fatigue), psychological distress (Hospital Anxiety and Depression Scale anxiety and depressive symptoms and Global Mood Scale negative and positive affect), and personality (Type D personality) were compared between patients with NOCAD and an age- and sex-matched group of 1347 people from the general population. Frequency matching was performed to obtain a similar sex distribution in each age–decile group. Both men and women with NOCAD reported impaired health status, more psychological distress, and Type D personality compared with men and women in the reference group. Women reported more psychosocial distress compared with men, but no significant sex-by-group interaction effects were observed. Women with NOCAD reported impaired health status, more anxiety, and less positive affect, but no differences in depressive symptoms, angina, or Type D personality when compared with men with NOCAD. Age, education, employment, partner, and alcohol use explained these S&G differences within the NOCAD group. 
Conclusions
In both men and women, NOCAD was associated with impaired health status, more psychological distress, and Type D personality when compared with a reference population. Factors reflecting S&G differences explained these S&G findings in patient-reported outcomes.
Original languageEnglish
Article numbere003597
JournalCirculation. Cardiovascular Quality and Outcomes
Volume10
Issue number2
DOIs
Publication statusPublished - 2017

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@article{71973e3a91744dab9cf654a8968e4ea4,
title = "Impaired health status, psychological distress, and personality in women and men with nonobstructive coronary artery disease: Sex and gender differences: The TWIST (Tweesteden Mild Stenosis Study)",
abstract = "BackgroundPatients with nonobstructive coronary artery disease (NOCAD; wall irregularities, stenosis <60{\%}), and women with NOCAD in particular, remain underinvestigated. We examined sex and gender (S&G) differences in health status, psychological distress, and personality between patients with NOCAD and the general population, as well as S&G differences within the NOCAD population.Methods and ResultsIn total, 523 patients with NOCAD (61±9 years, 52{\%} women) were included via coronary angiography and computed tomography as part of the TWIST (Tweesteden Mild Stenosis) study. Generic health status (12-item Short Form physical and mental scales and fatigue), psychological distress (Hospital Anxiety and Depression Scale anxiety and depressive symptoms and Global Mood Scale negative and positive affect), and personality (Type D personality) were compared between patients with NOCAD and an age- and sex-matched group of 1347 people from the general population. Frequency matching was performed to obtain a similar sex distribution in each age–decile group. Both men and women with NOCAD reported impaired health status, more psychological distress, and Type D personality compared with men and women in the reference group. Women reported more psychosocial distress compared with men, but no significant sex-by-group interaction effects were observed. Women with NOCAD reported impaired health status, more anxiety, and less positive affect, but no differences in depressive symptoms, angina, or Type D personality when compared with men with NOCAD. Age, education, employment, partner, and alcohol use explained these S&G differences within the NOCAD group. ConclusionsIn both men and women, NOCAD was associated with impaired health status, more psychological distress, and Type D personality when compared with a reference population. Factors reflecting S&G differences explained these S&G findings in patient-reported outcomes.",
author = "P.M.C. Mommersteeg and Lindy Arts and W.P. Zijlstra and J.W.C.M. Widdershoven and W. Aarnoudse and J. Denollet",
year = "2017",
doi = "10.1161/CIRCOUTCOMES.116.003387",
language = "English",
volume = "10",
journal = "Circulation. Cardiovascular Quality and Outcomes",
issn = "1941-7705",
publisher = "LIPPINCOTT WILLIAMS & WILKINS",
number = "2",

}

TY - JOUR

T1 - Impaired health status, psychological distress, and personality in women and men with nonobstructive coronary artery disease

T2 - Sex and gender differences: The TWIST (Tweesteden Mild Stenosis Study)

AU - Mommersteeg, P.M.C.

AU - Arts, Lindy

AU - Zijlstra, W.P.

AU - Widdershoven, J.W.C.M.

AU - Aarnoudse, W.

AU - Denollet, J.

PY - 2017

Y1 - 2017

N2 - BackgroundPatients with nonobstructive coronary artery disease (NOCAD; wall irregularities, stenosis <60%), and women with NOCAD in particular, remain underinvestigated. We examined sex and gender (S&G) differences in health status, psychological distress, and personality between patients with NOCAD and the general population, as well as S&G differences within the NOCAD population.Methods and ResultsIn total, 523 patients with NOCAD (61±9 years, 52% women) were included via coronary angiography and computed tomography as part of the TWIST (Tweesteden Mild Stenosis) study. Generic health status (12-item Short Form physical and mental scales and fatigue), psychological distress (Hospital Anxiety and Depression Scale anxiety and depressive symptoms and Global Mood Scale negative and positive affect), and personality (Type D personality) were compared between patients with NOCAD and an age- and sex-matched group of 1347 people from the general population. Frequency matching was performed to obtain a similar sex distribution in each age–decile group. Both men and women with NOCAD reported impaired health status, more psychological distress, and Type D personality compared with men and women in the reference group. Women reported more psychosocial distress compared with men, but no significant sex-by-group interaction effects were observed. Women with NOCAD reported impaired health status, more anxiety, and less positive affect, but no differences in depressive symptoms, angina, or Type D personality when compared with men with NOCAD. Age, education, employment, partner, and alcohol use explained these S&G differences within the NOCAD group. ConclusionsIn both men and women, NOCAD was associated with impaired health status, more psychological distress, and Type D personality when compared with a reference population. Factors reflecting S&G differences explained these S&G findings in patient-reported outcomes.

AB - BackgroundPatients with nonobstructive coronary artery disease (NOCAD; wall irregularities, stenosis <60%), and women with NOCAD in particular, remain underinvestigated. We examined sex and gender (S&G) differences in health status, psychological distress, and personality between patients with NOCAD and the general population, as well as S&G differences within the NOCAD population.Methods and ResultsIn total, 523 patients with NOCAD (61±9 years, 52% women) were included via coronary angiography and computed tomography as part of the TWIST (Tweesteden Mild Stenosis) study. Generic health status (12-item Short Form physical and mental scales and fatigue), psychological distress (Hospital Anxiety and Depression Scale anxiety and depressive symptoms and Global Mood Scale negative and positive affect), and personality (Type D personality) were compared between patients with NOCAD and an age- and sex-matched group of 1347 people from the general population. Frequency matching was performed to obtain a similar sex distribution in each age–decile group. Both men and women with NOCAD reported impaired health status, more psychological distress, and Type D personality compared with men and women in the reference group. Women reported more psychosocial distress compared with men, but no significant sex-by-group interaction effects were observed. Women with NOCAD reported impaired health status, more anxiety, and less positive affect, but no differences in depressive symptoms, angina, or Type D personality when compared with men with NOCAD. Age, education, employment, partner, and alcohol use explained these S&G differences within the NOCAD group. ConclusionsIn both men and women, NOCAD was associated with impaired health status, more psychological distress, and Type D personality when compared with a reference population. Factors reflecting S&G differences explained these S&G findings in patient-reported outcomes.

U2 - 10.1161/CIRCOUTCOMES.116.003387

DO - 10.1161/CIRCOUTCOMES.116.003387

M3 - Article

VL - 10

JO - Circulation. Cardiovascular Quality and Outcomes

JF - Circulation. Cardiovascular Quality and Outcomes

SN - 1941-7705

IS - 2

M1 - e003597

ER -