Personality traits, cardiac risk factors and their association with presence and severity of coronary artery plaque in people with no history of cardiovascular disease

Background: 
Coronary artery disease (CAD) is a multifactorial complex disease. The aim of the present study is to verify whether the personality traits in CAD are associated with coronary artery plaque (CAP) presence and severity in people with no history of cardiovascular disease.
Design: 
A cross-sectional monocenter study.
Methods: 
Seventy five individuals with no history of CAD underwent 64-slice computed tomography coronary angiography (CTCA) and were screened for traditional cardiac risk factors and for hostility, anger, and type D personality traits.Results: In total, 48 patients (64%) had evidence of CAP, with mild (31%), moderate (33%), and severe (35%) coronary stenosis. Male sex, hypertension, being overweight, and number of cardiovascular risk factors increased the likelihood of CAP presence. Findings showed a significant difference between CAP presence vs. CAP absence for anger (26 vs. 30%, χ2 = 6.82) and type D personality (23 vs. 35%; χ2 = 8.23, P = 0.03), but not hostility (P > 0.05). Anger personality, and the type D subscale social inhibition, but not negative affectivity, were associated with an increased prevalence and severity of CAP. Univariate analysis confirms anger (odds ratio, OR = 1.38, 95% confidence interval, CI = 1.12–2.31), social inhibition (OR = 2.01, 95% CI = 1.81–2.93), ‘negative affectivity by social inhibition’ (OR = 1.24, 95% CI = 1.12–2.14), and type D personality (OR = 1.9, 95% CI = 1.11–2.03) as predictors of CAP presence. Moreover, multivariate analysis suggests social inhibition as also a unique CAP predictor (OR = 2.14, 95% CI = 1.89–2.96) after adjustment for having cardiac risk factors as a covariate.
Conclusion: 
The present data confirm the core role of traditional risk factors and suggest the primacy of social inhibition and anger personality traits in association with CAP presence and severity.