Type D personality and cardiac mortality in patients with chronic heart failure

Clinical predictors of cardiac mortality in chronic heart failure (CHF) are established, but less is known about chronic psychological predictors. Therefore, we examined the prognostic value of Type D personality (tendency to experience negative feelings and inhibit self-expression) in CHF patients.

Consecutive systolic CHF outpatients (n=232) filled in the Type D Scale (DS14) at baseline. Socio-demographic and clinical data were obtained from the medical record/cardiologist. The primary endpoint was total cardiac mortality (follow-up=30.7+/-11.1 months). Late (>6 months) cardiac mortality was the secondary endpoint. Type D patients had a higher incidence of total cardiac mortality (15/48=31.3%) as compared to non Type D patients (32/184=17.4%), OR=2.16;95%CI:1.05-4.43, p=.04. Type D personality was a near significant independent predictor of total cardiac mortality (OR=1.40;95%CI:0.93-4.29, p=.08), and a significant independent predictor of late cardiac mortality, adjusting for sex, age and left ventricular ejection fraction (OR=2.34;95%CI:1.05-5.26, p=.04).

Type D personality was a near-significant independent predictor of total cardiac mortality, and a significant independent predictor of late cardiac mortality, adjusting for socio-demographics and disease-severity. These findings suggest that Type D personality, a chronic psychological risk factor, is of importance in long-term prognosis in CHF.