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Association between type D personality and prognosis in patients with cardiovascular diseases: a systematic review
Gesine Grande1, Matthias Romppel, Jürgen Barth
1Faculty of Applied Social Sciences, Leipzig University of Applied Sciences, Germany. grande@fas.htwk-leipzig.de
Background:
Since 1995, the association of type D personality and mortality in patients with cardiovascular diseases has been increasingly investigated.
Purpose:
The aim of this meta-analysis was to integrate conflicting results and to examine possible moderators of this association.
Methods:
Prospective studies assessing type D personality and hard endpoints were selected and pooled in meta-analyses. Cardiovascular diagnosis, type and quality of adjustment, and publication date were examined in moderator analyses.
Results:
Twelve studies on patients with cardiovascular diseases (N = 5,341) were included. Pooled crude and adjusted effects demonstrated a significant association of type D personality and hard endpoints (odds ratio (OR) of 2.28 (95% CI [1.43-3.62]), adjusted hazard ratio (HR) of 2.24 (95% CI [1.37-3.66])). The OR decreased over time (OR 5.02 to OR 1.54). There was no association in congestive heart failure patients.
Conclusions:
More recent methodologically sound studies suggest that early type D studies had overestimated the prognostic relevance.
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