The Impact of Type D Personality on Coronary Artery Disease Severity in Acute Coronary Syndrome Patients: Sex Differences

This cross-sectional study aimed to examine the association between type D personality and the severity of coronary artery disease in patients with acute coronary syndrome (ACS), with a specific focus on sex-stratified differences.

ACS patients (n=9236) completed the Chinese Type D Personality Scale. The Gensini score assessed disease severity. Multivariate linear regression, adjusted for covariates, analyzed the relationship between type D personality and Gensini score, with a sex stratified analysis exploring the impact of sex.

In total, 20.1% (1853) of ACS patients had a type D personality. Type D personality was measured using standardized scores of negative affectivity (Z-NA) and social inhibition (Z-SI). Multivariate linear regression analysis showed that Z-NA (B=0.03, 95% CI=0.02-0.05, p <.001), Z-SI (B=0.05, 95% CI=0.04-0.07, p <.001), and their interaction term (B=0.02, 95% CI=0.01-0.03, p <.001) were all significantly associated with the Gensini score [Ln]. Further sex-stratified analyses revealed that, among male patients, Z-NA (B=0.04, 95% CI=0.03-0.06, p <.001), Z-SI (B=0.06, 95% CI=0.04-0.07, p <.001), and their interaction (B=0.03, 95% CI=0.02-0.04, p <.001) were all significantly associated with the Gensini score [Ln]. However, no statistically significant associations were observed in female patients.

Sex differences significantly influence the relationship between type D personality and coronary disease severity in ACS patients, particularly in males, warranting targeted interventions.