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Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease
Denollet,J. van Felius,Romy A Lodder,P. Mommersteeg,P.M.C. Goovaerts,Inge Possemiers,Nadine Vanhees,Luc Beckers,Paul Pattyn,Nele Van Craenenbroeck,Emeline M
Denollet,J.
van Felius,Romy A
Lodder,P.
Mommersteeg,P.M.C.
Goovaerts,Inge
Possemiers,Nadine
Vanhees,Luc
Beckers,Paul
Pattyn,Nele
Van Craenenbroeck,Emeline M
Abstract
Background: Type D personality (high negative affectivity and social inhibition) is associated with cardiovascular events and coronary plaque severity. Whether Type D is also related to functional vasomotion abnormalities is unknown. We examined concurrent and predictive associations of Type D with endothelial dysfunction in patients with coronary artery disease (CAD). Methods: At baseline, 180 CAD patients (90% men; M = 58.0 years) completed Type D (DS14) and depression scales, and entered a 12-week exercise program. Flow-mediated dilation (FMD) of the brachial artery and circulating CD34+/KDR+/CD45+dim endothelial progenitor cells (EPCs) were assessed at baseline, 3 months, and 12 months. Logistic regression and linear mixed models were used to analyze endothelial function. Results: Type D personality was associated with decreased FMD across baseline, 3 months, and 12 months (mixed model analysis, p = 0.04), after adjustment for clinical characteristics, exercise training and depression. There was no significant association between Type D and decreased EPCs (p = 0.07). Age and smoking were other significant correlates of FMD and EPCs. Using a FMD <5.5% cut-off, Type D patients more often had endothelial dysfunction at baseline (24/37 = 65%) than non-Type Ds (63/143 = 44%); OR = 3.03, 95% CI 1.04-8.80. This significant Type D effect was confirmed in prospective analyses of endothelial dysfunction at 12 months (OR = 3.43, 95% CI 1.01-11.64), and in subgroup analyses of male patients. Conclusions: Type D personality was associated with impaired endothelial function in men with CAD. This association was robust across time, independent from depressive symptoms, and supports the notion that Type D has an adverse effect on cardiovascular health in patients with CAD.
Description
Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.
Date
2018
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Research Projects
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Keywords
CARDIOVASCULAR-DISEASE, Coronary artery disease, Depression, EUROPEAN-SOCIETY, Endothelial dysfunction, FLOW-MEDIATED DILATION, FMD, HEART-DISEASE, MENTAL STRESS, NEGATIVE AFFECTIVITY, POSITION PAPER, PROGENITOR CELLS, RISK-FACTORS, SOCIAL INHIBITION, Type D personality, SDG 3 - Good Health and Well-being
Citation
Denollet, J, van Felius, R A, Lodder, P, Mommersteeg, P M C, Goovaerts, I, Possemiers, N, Vanhees, L, Beckers, P, Pattyn, N & Van Craenenbroeck, E M 2018, 'Predictive value of Type D personality for impaired endothelial function in patients with coronary artery disease', International Journal of Cardiology, vol. 259, pp. 205-210. https://doi.org/10.1016/j.ijcard.2018.02.064
License
info:eu-repo/semantics/openAccess