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  • 1From the Department of Methodology and Statistics (Lodder, Wicherts), and Center of Research on Psychology in Somatic diseases (CoRPS) (Lodder, Antens, Kupper), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands;Department of Psychosomatics and Psychotherapy (Albus), University of Cologne, Medical Faculty and University Hospital, Cologne, Germany; Tyumen Cardiology Research Center (Bessonov, Pushkarev), Tomsk National Research Medical Center, Russian Academy of Science, Tyumen, Russia; Uppsala University, Centre for Clinical Research (Condén), Hospital of Västmanland, Västmanland, Sweden; Intensive Care Unit, Department of Pediatrics and Pediatric Surgery (Dulfer), Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Psychology (Gostoli, Rafanelli), University of Bologna, Bologna, Italy; Brandenburgische Technische Universität Cottbus-Senftenberg (Grande), Cottbus, Germany; Department of Clinical Physiology and Centre for Clinical Research (Hedberg), Uppsala University, Västmanland County Hospital, Västerås, Sweden; Department of Psychosomatic Medicine and Psychotherapy (Herrmann-Lingen, Meyer), University of Göttingen Medical Center and German Center for Cardiovascular Research (DZHK), partner site Göttingen, Germany; Department of Health, Medicine and Caring Sciences (Jaarsma), Linköping University, Linköping, Sweden; Graduate Institute of Long-term Care (Koo), Tzu Chi University of Science and Technology, Hualien City, Hualien, Taiwan;Dalla Lana School of Public Health (Koo), University of Toronto, Toronto, Ontario, Canada;College of Nursing of Harbin Medical University (P. Lin), The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Division of Cardiology, Department of Internal Medicine (T.-K. Lin), Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi; School of Medicine, Tzu Chi University (T.-K. Lin), Hualien City, Hualien, Taiwan; Laboratory of Comorbidity in Cardiovascular Diseases (Raykh, Sumin), Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", Moscow, Russian Federation; Institute of Cardiology (Schaan de Quadros, Schmidt), University Foundation of Cardiology, Porto Alegre, Rio Grande do Sul, Brazil; Research Institute of Child Development and Education (Utens), Amsterdam UMC/ Level, Amsterdam; Department of Cardiology, University of Groningen (van Veldhuisen), University Medical Center Groningen, Groningen, the Netherlands; and Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University (Wang), Harbin, China.

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Summary

Type D personality predicts adverse events in cardiovascular disease patients, particularly in coronary artery disease. However, its effect on mortality outcomes was not significant across studies.

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Area of Science:

  • Cardiology
  • Psychosomatic Medicine
  • Clinical Epidemiology

Background:

  • Type D personality, characterized by negative affectivity and social inhibition, has inconsistently predicted adverse outcomes in cardiovascular disease patients.
  • This study addresses inconsistencies by performing an individual patient-data meta-analysis.

Approach:

  • A meta-analysis of 19 prospective cohort studies (N=11,151) was conducted.
  • Prognostic influence of Type D personality on major adverse cardiac events, mortality, and revascularization was assessed.
  • Moderation by age, sex, and disease type (coronary artery disease vs. heart failure) was examined.

Key Points:

  • Type D personality strongly predicted major adverse cardiac events (BF=42.5) and any adverse event (BF=129.4).
  • Evidence for a null effect of Type D personality was found for all-cause mortality (BF=45.9), cardiac mortality (BF=23.7), and myocardial infarction (BF=16.9).
  • Findings were consistent in coronary artery disease patients but inconclusive in heart failure patients.

Conclusions:

  • Type D personality predicts adverse events in coronary artery disease patients.
  • No significant effect of Type D personality was observed on cardiac or all-cause mortality in either coronary artery disease or heart failure patients.
  • Negative affectivity showed a positive effect on cardiac and all-cause mortality, especially in males.