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

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 fromdepressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD. (c) 2018 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license

Jaar van publicatie:2018

BOF-keylabel:ja

CSS-citation score:1

Auteurs:International

Authors from:Higher Education

Toegankelijkheid:Open