TY - JOUR
T1 - Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease
AU - Denollet, J.
AU - van Felius, Romy A
AU - Lodder, P.
AU - Mommersteeg, P.M.C.
AU - Goovaerts, Inge
AU - Possemiers, Nadine
AU - Vanhees, Luc
AU - Beckers, Paul
AU - Pattyn, Nele
AU - Van Craenenbroeck, Emeline M
N1 - Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.
PY - 2018
Y1 - 2018
N2 - 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 from depressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD.
AB - 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 from depressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD.
KW - CARDIOVASCULAR-DISEASE
KW - Coronary artery disease
KW - Depression
KW - EUROPEAN-SOCIETY
KW - Endothelial dysfunction
KW - FLOW-MEDIATED DILATION
KW - FMD
KW - HEART-DISEASE
KW - MENTAL STRESS
KW - NEGATIVE AFFECTIVITY
KW - POSITION PAPER
KW - PROGENITOR CELLS
KW - RISK-FACTORS
KW - SOCIAL INHIBITION
KW - Type D personality
U2 - 10.1016/j.ijcard.2018.02.064
DO - 10.1016/j.ijcard.2018.02.064
M3 - Article
C2 - 29477262
SN - 0167-5273
VL - 259
SP - 205
EP - 210
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -