Nina Kupper1, Johan Denollet2. 1. CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands. Electronic address: h.m.kupper@tilburguniversity.edu. 2. CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands.
Abstract
BACKGROUND: Type D personality has been associated with adverse outcomes in patients with coronary artery disease (CAD). However, large heterogeneity exists between Type D studies, including some studies reporting null-findings. OBJECTIVES: The aim of this study was to examine i) choice of endpoint and ii) age as two study characteristics that may partly explain this large heterogeneity in the Type D associated prognostic effect. METHODS: We used four existing data cohorts of 1503 CAD patients (89% male, mean age=57.2±9.1) with baseline measures of Type D and endpoints >5years follow-up: major adverse cardiac events (MACE), cardiac death/MI, and non-cardiac death. Patients were classified in 4 age categories: <50y, 50-59y, 60-69y and ≥70y. Multiple logistic regression models included age, sex, and clinical covariates. RESULTS: At follow-up, there were 295 events, including 116 cardiac death/MI, and 37 non-cardiac deaths. Both continuous and categorical measures of Type D predicted adverse events. Type D was independently associated with MACE (OR=1.82; 95%CI 1.33-2.50) and cardiac death/MI (OR=2.49; 95%CI 1.55-3.99). However, Type D was not associated with non-cardiac death (OR=1.23; 95%CI 0.57-2.69). Regarding age, Type D consistently predicted MACE in the lower age groups (all ORs≥2.20, all ps≤.004), but not in patients aged ≥70y (OR=1.43, p=.57). CONCLUSIONS: Choice of endpoint and age modulated the risk conferred by Type D personality. Type D was associated with an increased risk of cardiac events, but not with non-cardiac death, or with events in patients aged ≥70y. Research on psychosocial risk in CAD should account for different sources of heterogeneity in study characteristics.
BACKGROUND: Type D personality has been associated with adverse outcomes in patients with coronary artery disease (CAD). However, large heterogeneity exists between Type D studies, including some studies reporting null-findings. OBJECTIVES: The aim of this study was to examine i) choice of endpoint and ii) age as two study characteristics that may partly explain this large heterogeneity in the Type D associated prognostic effect. METHODS: We used four existing data cohorts of 1503 CAD patients (89% male, mean age=57.2±9.1) with baseline measures of Type D and endpoints >5years follow-up: major adverse cardiac events (MACE), cardiac death/MI, and non-cardiac death. Patients were classified in 4 age categories: <50y, 50-59y, 60-69y and ≥70y. Multiple logistic regression models included age, sex, and clinical covariates. RESULTS: At follow-up, there were 295 events, including 116 cardiac death/MI, and 37 non-cardiac deaths. Both continuous and categorical measures of Type D predicted adverse events. Type D was independently associated with MACE (OR=1.82; 95%CI 1.33-2.50) and cardiac death/MI (OR=2.49; 95%CI 1.55-3.99). However, Type D was not associated with non-cardiac death (OR=1.23; 95%CI 0.57-2.69). Regarding age, Type D consistently predicted MACE in the lower age groups (all ORs≥2.20, all ps≤.004), but not in patients aged ≥70y (OR=1.43, p=.57). CONCLUSIONS: Choice of endpoint and age modulated the risk conferred by Type D personality. Type D was associated with an increased risk of cardiac events, but not with non-cardiac death, or with events in patients aged ≥70y. Research on psychosocial risk in CAD should account for different sources of heterogeneity in study characteristics.
Authors: Johan S Bundgaard; Lauge Østergaard; Gunnar Gislason; Jens J Thune; Jens C Nielsen; Jens Haarbo; Lars Videbæk; Line L Olesen; Anna M Thøgersen; Christian Torp-Pedersen; Susanne S Pedersen; Lars Køber; Ulrik M Mogensen Journal: Qual Life Res Date: 2019-07-10 Impact factor: 4.147
Authors: Andrzej Witusik; Łukasz Mokros; Marcin Kosmalski; Michał Panek; Katarzyna Nowakowska-Domagała; Kasper Sipowicz; Piotr Kuna; Tadeusz Pietras Journal: Postepy Dermatol Alergol Date: 2018-08-21 Impact factor: 1.837