Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease

J. Denollet, Romy A van Felius, P. Lodder, P.M.C. Mommersteeg, Inge Goovaerts, Nadine Possemiers, Luc Vanhees, Paul Beckers, Nele Pattyn, Emeline M Van Craenenbroeck

Research output: Contribution to journalArticleScientificpeer-review

9 Citations (Scopus)
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Abstract

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.

Original languageEnglish
Pages (from-to)205-210
JournalInternational Journal of Cardiology
Volume259
DOIs
Publication statusPublished - 2018

Keywords

  • CARDIOVASCULAR-DISEASE
  • Coronary artery disease
  • Depression
  • EUROPEAN-SOCIETY
  • Endothelial dysfunction
  • FLOW-MEDIATED DILATION
  • FMD
  • HEART-DISEASE
  • MENTAL STRESS
  • NEGATIVE AFFECTIVITY
  • POSITION PAPER
  • PROGENITOR CELLS
  • RISK-FACTORS
  • SOCIAL INHIBITION
  • Type D personality

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