TY - JOUR
T1 - Type D personality as a risk factor for adverse outcome in patients with cardiovascular disease
T2 - An individual patient data meta-analysis
AU - Lodder, Paul
AU - Wicherts, Jelte M
AU - Antens, Marijn
AU - Albus, Christian
AU - Bessonov, Ivan S
AU - Condén, Emelie
AU - Dulfer, Karolijn
AU - Gostoli, Sara
AU - Grande, Gesine
AU - Hedberg, Pär
AU - Herrmann-Lingen, Christoph
AU - Jaarsma, Tiny
AU - Koo, Malcolm
AU - Lin, Ping
AU - Lin, Tin-Kwang
AU - Meyer, Thomas
AU - Pushkarev, Georgiy
AU - Rafanelli, Chiara
AU - Raykh, Olga I
AU - de Quadros, Alexandre Schaan
AU - Schmidt, Marcia
AU - Sumin, Alexei N
AU - Utens, Elisabeth M W J
AU - van Veldhuisen, Dirk J
AU - Wang, Yini
AU - Kupper, Nina
N1 - The research of Jelte Wicherts is funded by consolidator grant 726361 (IMPROVE project) from the European Research Council (ERC).
PY - 2023
Y1 - 2023
N2 - Objective Type D personality, a joint tendency toward negative affectivity and social inhibition, has been linked to adverse events in patients with heart disease, although with inconsistent findings. Here, we apply an individual patient-data meta-analysis to data from 19 prospective cohort studies (N = 11,151) to investigate the prediction of adverse outcomes by type D personality in patients with acquired cardiovascular disease. Method For each outcome (all-cause mortality, cardiac mortality, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, major adverse cardiac event, any adverse event), we estimated type D's prognostic influence and the moderation by age, sex, and disease type. Results In patients with cardiovascular disease, evidence for a type D effect in terms of the Bayes factor (BF) was strong for major adverse cardiac event (BF = 42.5; odds ratio [OR] = 1.14) and any adverse event (BF = 129.4; OR = 1.15). Evidence for the null hypothesis was found for all-cause mortality (BF = 45.9; OR = 1.03), cardiac mortality (BF = 23.7; OR = 0.99), and myocardial infarction (BF = 16.9; OR = 1.12), suggesting that type D had no effect on these outcomes. This evidence was similar in the subset of patients with coronary artery disease (CAD), but inconclusive for patients with heart failure (HF). Positive effects were found for negative affectivity on cardiac and all-cause mortality, with the latter being more pronounced in male than female patients. Conclusion Across 19 prospective cohort studies, type D predicts adverse events in patients with CAD, whereas evidence in patients with HF was inconclusive. In both patients with CAD and HF, we found evidence for a null effect of type D on cardiac and all-cause mortality.
AB - Objective Type D personality, a joint tendency toward negative affectivity and social inhibition, has been linked to adverse events in patients with heart disease, although with inconsistent findings. Here, we apply an individual patient-data meta-analysis to data from 19 prospective cohort studies (N = 11,151) to investigate the prediction of adverse outcomes by type D personality in patients with acquired cardiovascular disease. Method For each outcome (all-cause mortality, cardiac mortality, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, major adverse cardiac event, any adverse event), we estimated type D's prognostic influence and the moderation by age, sex, and disease type. Results In patients with cardiovascular disease, evidence for a type D effect in terms of the Bayes factor (BF) was strong for major adverse cardiac event (BF = 42.5; odds ratio [OR] = 1.14) and any adverse event (BF = 129.4; OR = 1.15). Evidence for the null hypothesis was found for all-cause mortality (BF = 45.9; OR = 1.03), cardiac mortality (BF = 23.7; OR = 0.99), and myocardial infarction (BF = 16.9; OR = 1.12), suggesting that type D had no effect on these outcomes. This evidence was similar in the subset of patients with coronary artery disease (CAD), but inconclusive for patients with heart failure (HF). Positive effects were found for negative affectivity on cardiac and all-cause mortality, with the latter being more pronounced in male than female patients. Conclusion Across 19 prospective cohort studies, type D predicts adverse events in patients with CAD, whereas evidence in patients with HF was inconclusive. In both patients with CAD and HF, we found evidence for a null effect of type D on cardiac and all-cause mortality.
KW - ALL-CAUSE MORTALITY
KW - BF = Bayes factor
KW - CABG = coronary artery bypass grafting
KW - CAD = coronary artery disease
KW - CARDIAC EVENTS
KW - CORONARY-ARTERY-DISEASE
KW - CVD = cardiovascular disease
KW - HEART-DISEASE
KW - MACE = major adverse cardiac event
KW - MYOCARDIAL-INFARCTION
KW - NA = negative affectivity
KW - NEGATIVE AFFECTIVITY
KW - OR = odds ratio
KW - PCI = percutaneous coronary intervention
KW - PREDICTIVE-VALUE
KW - PSYCHOLOGICAL DISTRESS
KW - QUALITY-OF-LIFE
KW - SI = social inhibition
KW - SOCIAL INHIBITION
KW - cardiac events
KW - cardiovascular disease
KW - meta-analysis
KW - negative affectivity
KW - type D personality
UR - http://www.scopus.com/inward/record.url?scp=85148036634&partnerID=8YFLogxK
U2 - 10.1097/PSY.0000000000001164
DO - 10.1097/PSY.0000000000001164
M3 - Article
C2 - 36640440
SN - 0033-3174
VL - 85
SP - 188
EP - 202
JO - Psychosomatic Medicine
JF - Psychosomatic Medicine
IS - 2
ER -