Hostname: page-component-669899f699-7xsfk Total loading time: 0 Render date: 2025-04-25T15:05:45.481Z Has data issue: false hasContentIssue false
  • English
  • Français

The combined impact of Type D personality and depression on cardiovascular events after acute myocardial infarction

Published online by Cambridge University Press:  02 August 2021

Yini Wang ,
Xueqin Gao ,
Zhenjuan Zhao ,
Ling Li ,
Guojie Liu ,
Hui Tao ,
Xi Yu ,
Bo Yu  and
Ping Lin
Yini Wang
Affiliation:
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
Xueqin Gao
Affiliation:
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
Zhenjuan Zhao
Affiliation:
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
Ling Li*
Affiliation:
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
Guojie Liu
Affiliation:
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
Hui Tao
Affiliation:
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
Xi Yu
Affiliation:
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
Bo Yu*
Affiliation:
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
Ping Lin*
Affiliation:
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
*
Authors for correspondence: Ping Lin, E-mail: linping_1962@163.com; Bo Yu, E-mail: yubodr@163.com
Authors for correspondence: Ping Lin, E-mail: linping_1962@163.com; Bo Yu, E-mail: yubodr@163.com
Authors for correspondence: Ping Lin, E-mail: linping_1962@163.com; Bo Yu, E-mail: yubodr@163.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Type D personality and depression are the independent psychological risk factors for adverse outcomes in cardiovascular patients. The aim of this study was to examine the combined effect of Type D personality and depression on clinical outcomes in patients suffering from acute myocardial infarction (AMI).

Methods

This prospective cohort study included 3568 patients diagnosed with AMI between February 2017 and September 2018. Type D personality and depression were assessed at baseline, while the major adverse cardiac event (MACE) rate (cardiac death, recurrent non-fatal myocardial infarction, revascularization, and stroke) and in-stent restenosis (ISR) rate were analyzed after a 2-year follow-up period.

Results

A total of 437 patients developed MACEs and 185 had ISR during the follow-up period. The Type D (+) depression (+) and Type D (+) depression (−) groups had a higher risk of MACE [95% confidence interval (CI) 1.74–6.07] (95% CI 1.25–2.96) and ISR (95% CI 3.09–8.28) (95% CI 1.85–6.22). Analysis of Type D and depression as continuous variables indicated that the main effect of Type D, depression and their combined effect were significantly associated with MACE and ISR. Moreover, Type D (+) depression (+) and Type D (+) depression (−) emerged as significant risk factors for MACE and ISR in males, while only Type D (+) depression (+) was associated with MACE and ISR in female patients.

Conclusions

These findings suggest that patients complicated with depression and Type D personality are at a higher risk of adverse cardiovascular outcomes. Individual assessments of Type D personality and depression, and comprehensive interventions are required.

Keywords

Acute myocardial infarctioncardiovascular eventsdepressionin-stent restenosisType D personality
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 4 , March 2023 , pp. 1379 - 1389
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

AbuRuz, M. E., & Al-Dweik, G. (2018). Depressive symptoms and complications early after acute myocardial infarction: Gender differences. Open Nursing Journal, 12, 205–214. doi:10.2174/1874434601812010205.CrossRefGoogle ScholarPubMed
Ang, L., Behnamfar, O., Palakodeti, S., Lin, F., Pourdjabbar, A., Patel, M. P., … Mahmud, E. (2017). Elevated baseline serum fibrinogen: Effect on 2-year major adverse cardiovascular events following percutaneous coronary intervention. Journal of the American Heart Association, 6(11), e006580. doi:10.1161/JAHA.117.006580.CrossRefGoogle ScholarPubMed
Beutel, M. E., Wiltink, J., Till, Y., Wild, P. S., Munzel, T., Ojeda, F. M., … Michal, M. (2012). Type D personality as a cardiovascular risk marker in the general population: Results from the Gutenberg health study. Psychotherapy and Psychosomatics, 81(2), 108–117. doi:10.1159/000331776.CrossRefGoogle ScholarPubMed
Cetin, M. S., Ozcan Cetin, E. H., Kalender, E., Aydin, S., Topaloglu, S., Kisacik, H. L., & Temizhan, A. (2016). Monocyte to HDL cholesterol ratio predicts coronary artery disease severity and future major cardiovascular adverse events in acute coronary syndrome. Heart, Lung & Circulation, 25(11), 1077–1086. doi:10.1016/j.hlc.2016.02.023.CrossRefGoogle ScholarPubMed
Cheng, F., Lin, P., Wang, Y., Liu, G., Li, L., Yu, H., … Gao, X. (2018). Type D personality and coronary atherosclerotic plaque vulnerability: The potential mediating effect of health behavior. Journal of Psychosomatic Research, 108, 54–60. doi:10.1016/j.jpsychores.2018.02.007.CrossRefGoogle ScholarPubMed
Cocchio, S., Baldovin, T., Furlan, P., Buja, A., Casale, P., Fonzo, M., … Bertoncello, C. (2019). Is depression a real risk factor for acute myocardial infarction mortality? A retrospective cohort study. BMC Psychiatry, 19(1), 122. doi:10.1186/s12888-019-2113-8CrossRefGoogle ScholarPubMed
Conden, E., Rosenblad, A., Wagner, P., Leppert, J., Ekselius, L., & Aslund, C. (2017). Is Type D personality an independent risk factor for recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients? European Journal of Preventive Cardiology, 24(5), 522–533. doi:10.1177/2047487316687427.CrossRefGoogle ScholarPubMed
Coyne, J. C., & de Voogd, J. N. (2012). Are we witnessing the decline effect in the Type D personality literature? What can be learned? Journal of Psychosomatic Research, 73(6), 401–407. doi:10.1016/j.jpsychores.2012.09.016.CrossRefGoogle ScholarPubMed
Coyne, J. C., Jaarsma, T., Luttik, M. L., van Sonderen, E., van Veldhuisen, D. J., & Sanderman, R. (2011). Lack of prognostic value of Type D personality for mortality in a large sample of heart failure patients. Psychosomatic Medicine, 73(7), 557–562. doi:10.1097/PSY.0b013e318227ac75.CrossRefGoogle Scholar
Dangas, G. D., Claessen, B. E., Caixeta, A., Sanidas, E. A., Mintz, G. S., & Mehran, R. (2010). In-stent restenosis in the drug-eluting stent era. Journal of the American College of Cardiology, 56(23), 1897–1907. doi:10.1016/j.jacc.2010.07.028.CrossRefGoogle Scholar
Denollet, J. (2005). DS14: standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosomatic Medicine, 67(1), 89–97. doi:10.1097/01.psy.0000149256.81953.49.CrossRefGoogle Scholar
Denollet, J., van Felius, R. A., Lodder, P., Mommersteeg, P. M., Goovaerts, I., Possemiers, N., … Van Craenenbroeck, E. M. (2018). Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease. International Journal of Cardiology, 259, 205–210. doi:10.1016/j.ijcard.2018.02.064.CrossRefGoogle Scholar
Ferguson, E., Williams, L., O'Connor, R. C., Howard, S., Hughes, B. M., Johnston, D. W., … O'Carroll, R. E. (2009). A taxometric analysis of type-D personality. Psychosomatic Medicine, 71(9), 981–986. doi:10.1097/PSY.0b013e3181bd888b.CrossRefGoogle ScholarPubMed
Furlanetto, L. M., Mendlowicz, M. V., & Romildo Bueno, J. (2005). The validity of the Beck Depression Inventory-Short Form as a screening and diagnostic instrument for moderate and severe depression in medical inpatients. Journal of Affective Disorders, 86(1), 87–91. doi:10.1016/j.jad.2004.12.011.CrossRefGoogle ScholarPubMed
Guerrero-Pinedo, F., Ochoa-Zarate, L., Salazar, C. J., Carrillo-Gomez, D. C., Paulo, M., Florez-Elvira, L. J., & Velasquez-Norena, J. G. (2020). Association of traditional cardiovascular risk factors in adults younger than 55 years with coronary heart disease. Case-control study. Sage Open Medicine, 8, 2050312120932703. doi:10.1177/2050312120932703.CrossRefGoogle ScholarPubMed
Imbalzano, E., Vatrano, M., Quartuccio, S., Ceravolo, R., Ciconte, V. A., Rotella, P., … Mandraffino, G. (2018). Effect of Type D personality on smoking status and their combined impact on outcome after acute myocardial infarction. Clinical Cardiology, 41(3), 321–325. doi:10.1002/clc.22865.CrossRefGoogle ScholarPubMed
Kabutoya, T., Hoshide, S., Davidson, K. W., & Kario, K. (2018). Sex differences and the prognosis of depressive and nondepressive patients with cardiovascular risk factors: The Japan morning surge-home blood pressure (J-HOP) study. Hypertension Research, 41(11), 965–972. doi:10.1038/s41440-018-0103-8.CrossRefGoogle ScholarPubMed
Kupper, N., & Denollet, J. (2018). Type D personality as a risk factor in coronary heart disease: A review of current evidence. Current Cardiology Reports, 20(11), 104. doi:10.1007/s11886-018-1048-x.CrossRefGoogle ScholarPubMed
Lee, R., Yu, H., Gao, X., Cao, J., Tao, H., Yu, B., … Lin, P. (2019). The negative affectivity dimension of Type D personality is associated with in-stent neoatherosclerosis in coronary patients with percutaneous coronary intervention: An optical coherence tomography study. Journal of Psychosomatic Research, 120, 20–28. doi:10.1016/j.jpsychores.2019.03.007.CrossRefGoogle ScholarPubMed
Lodder, P. (2020). Modeling synergy: How to assess a Type D personality effect. Journal of Psychosomatic Research, 132, 109990. doi:10.1016/j.jpsychores.2020.109990.CrossRefGoogle ScholarPubMed
Masafi, S., Saadat, S. H., Tehranchi, K., Olya, R., Heidari, M., Malihialzackerini, S., … Rajabi, E. (2018). Effect of stress, depression and Type D personality on immune system in the incidence of coronary artery disease. Open Access Macedonian Journal of Medical Sciences, 6(8), 1533–1544. doi:10.3889/oamjms.2018.217.CrossRefGoogle ScholarPubMed
Meng, R., Yu, C., Liu, N., He, M., Lv, J., & Guo, Y., … China Kadoorie Biobank Collaborative Group (2020). Association of depression with all-cause and cardiovascular disease mortality among adults in China. JAMA Network Open, 3(2), e1921043. doi:10.1001/jamanetworkopen.2019.21043.CrossRefGoogle ScholarPubMed
Nicholson, B., Morse, S., Lundgren, T., Vadiei, N., & Bhattacharjee, S. (2020). Effect of depression on health behavior among myocardial infarction survivors in the United States. Mental Health Clinician, 10(4), 222–231. doi:10.9740/mhc.2020.07.222.CrossRefGoogle ScholarPubMed
Ossola, P., De Panfilis, C., Tonna, M., Ardissino, D., & Marchesi, C. (2015). DS14 is more likely to measure depression rather than a personality disposition in patients with acute coronary syndrome. Scandinavian Journal of Psychology, 56(6), 685–692. doi:10.1111/sjop.12244.CrossRefGoogle ScholarPubMed
Authors/Task Force, Members, Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., … Zamorano, J. L. (2016). 2016 European guidelines on cardiovascular disease prevention in clinical practice: The sixth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts): Developed with the special contribution of the European association for cardiovascular prevention & rehabilitation (EACPR). European Journal of Preventive Cardiology, 23(11), NP1–NP96. doi:10.1177/2047487316653709.Google Scholar
Pimple, P., Lima, B. B., Hammadah, M., Wilmot, K., Ramadan, R., Levantsevych, O., … Vaccarino, V. (2019). Psychological distress and subsequent cardiovascular events in individuals with coronary artery disease. Journal of the American Heart Association, 8(9), e011866. doi:10.1161/JAHA.118.011866.CrossRefGoogle ScholarPubMed
Riordan, A. O., Howard, S., & Gallagher, S. (2019). Social context and sex moderate the association between Type D personality and cardiovascular reactivity. Applied Psychophysiology and Biofeedback, 44(4), 321–330. doi:10.1007/s10484-019-09447-x.CrossRefGoogle ScholarPubMed
Shang, P., Liu, G. G., Zheng, X., Ho, P. M., Hu, S., Li, J., … Krumholz, H. M. (2019). Association between medication adherence and 1-year major cardiovascular adverse events after acute myocardial infarction in China. Journal of the American Heart Association, 8(9), e011793. doi:10.1161/JAHA.118.011793.CrossRefGoogle ScholarPubMed
Sogaro, E., Schinina, F., Burgisser, C., Orso, F., Pallante, R., Aloi, T., … Fattirolli, F. (2010). Type D personality impairs quality of life, coping and short-term psychological outcome in patients attending an outpatient intensive program of cardiac rehabilitation. Monaldi Archives for Chest Disease. Archivio Monaldi per Le Malattie Del Torace, 74(4), 181–191. doi:10.4081/monaldi.2010.259.Google ScholarPubMed
Son, Y. J., Lee, K., Morisky, D. E., & Kim, B. H. (2018). Impacts of Type D personality and depression, alone and in combination, on medication non-adherence following percutaneous coronary intervention. International Journal of Environmental Research and Public Health, 15(10). doi:10.3390/ijerph15102226.CrossRefGoogle ScholarPubMed
van Dooren, F. E., Verhey, F. R., Pouwer, F., Schalkwijk, C. G., Sep, S. J., Stehouwer, C. D., … Denollet, J. (2016). Association of Type D personality with increased vulnerability to depression: Is there a role for inflammation or endothelial dysfunction? – The Maastricht study. Journal of Affective Disorders, 189, 118–125. doi:10.1016/j.jad.2015.09.028.CrossRefGoogle ScholarPubMed
van Montfort, E., Mommersteeg, P., Spek, V., & Kupper, N. (2018). Latent profiles of early trauma & Type D personality: Sex differences in cardiovascular risk markers. Comprehensive Psychiatry, 83, 38–45. doi:10.1016/j.comppsych.2018.02.009.CrossRefGoogle ScholarPubMed
Wang, Y., Liu, G., Gao, X., Zhao, Z., Li, L., Chen, W., … Lin, P. (2018). Prognostic value of Type D personality for in-stent restenosis in coronary artery disease patients treated with drug-eluting stent. Psychosomatic Medicine, 80(1), 95–102. doi:10.1097/PSY.0000000000000532.CrossRefGoogle ScholarPubMed
Wang, Y., Zhao, Z., Gao, X., Li, L., Liu, G., Chen, W., … Lin, P. (2016). Type D personality and coronary plaque vulnerability in patients with coronary artery disease: An optical coherence tomography study. Psychosomatic Medicine, 78(5), 583–592. doi:10.1097/PSY.0000000000000307.CrossRefGoogle ScholarPubMed
Supplementary material: Image

Wang et al. supplementary material

Wang et al. supplementary material 1

Download Wang et al. supplementary material(Image)
Image 9.3 MB
Supplementary material: Image

Wang et al. supplementary material

Wang et al. supplementary material 2

Download Wang et al. supplementary material(Image)
Image 11.9 MB