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Type D personality as a risk factor for adverse outcome in patients with cardiovascular disease: An individual patient data meta-analysis
Lodder,Paul Wicherts,Jelte M Antens,Marijn Albus,Christian Bessonov,Ivan S Condén,Emelie Dulfer,Karolijn Gostoli,Sara Grande,Gesine Hedberg,Pär
Lodder,Paul
Wicherts,Jelte M
Antens,Marijn
Albus,Christian
Bessonov,Ivan S
Condén,Emelie
Dulfer,Karolijn
Gostoli,Sara
Grande,Gesine
Hedberg,Pär
Abstract
Objective Type D personality, a joint tendency toward negative affectivity and social inhibition, has been linked to adverse events in patients with heart disease, although with inconsistent findings. Here, we apply an individual patient-data meta-analysis to data from 19 prospective cohort studies (N = 11,151) to investigate the prediction of adverse outcomes by type D personality in patients with acquired cardiovascular disease. Method For each outcome (all-cause mortality, cardiac mortality, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, major adverse cardiac event, any adverse event), we estimated type D's prognostic influence and the moderation by age, sex, and disease type. Results In patients with cardiovascular disease, evidence for a type D effect in terms of the Bayes factor (BF) was strong for major adverse cardiac event (BF = 42.5; odds ratio [OR] = 1.14) and any adverse event (BF = 129.4; OR = 1.15). Evidence for the null hypothesis was found for all-cause mortality (BF = 45.9; OR = 1.03), cardiac mortality (BF = 23.7; OR = 0.99), and myocardial infarction (BF = 16.9; OR = 1.12), suggesting that type D had no effect on these outcomes. This evidence was similar in the subset of patients with coronary artery disease (CAD), but inconclusive for patients with heart failure (HF). Positive effects were found for negative affectivity on cardiac and all-cause mortality, with the latter being more pronounced in male than female patients. Conclusion Across 19 prospective cohort studies, type D predicts adverse events in patients with CAD, whereas evidence in patients with HF was inconclusive. In both patients with CAD and HF, we found evidence for a null effect of type D on cardiac and all-cause mortality.
Description
The research of Jelte Wicherts is funded by consolidator grant 726361 (IMPROVE project) from the European Research Council (ERC).
Date
2023
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Research Projects
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Keywords
ALL-CAUSE MORTALITY, BF = Bayes factor, CABG = coronary artery bypass grafting, CAD = coronary artery disease, CARDIAC EVENTS, CORONARY-ARTERY-DISEASE, CVD = cardiovascular disease, HEART-DISEASE, MACE = major adverse cardiac event, MYOCARDIAL-INFARCTION, NA = negative affectivity, NEGATIVE AFFECTIVITY, OR = odds ratio, PCI = percutaneous coronary intervention, PREDICTIVE-VALUE, PSYCHOLOGICAL DISTRESS, QUALITY-OF-LIFE, SI = social inhibition, SOCIAL INHIBITION, cardiac events, cardiovascular disease, meta-analysis, negative affectivity, type D personality, SDG 3 - Good Health and Well-being
Citation
Lodder, P, Wicherts, J M, Antens, M, Albus, C, Bessonov, I S, Condén, E, Dulfer, K, Gostoli, S, Grande, G, Hedberg, P, Herrmann-Lingen, C, Jaarsma, T, Koo, M, Lin, P, Lin, T-K, Meyer, T, Pushkarev, G, Rafanelli, C, Raykh, O I, de Quadros, A S, Schmidt, M, Sumin, A N, Utens, E M W J, van Veldhuisen, D J, Wang, Y & Kupper, N 2023, 'Type D personality as a risk factor for adverse outcome in patients with cardiovascular disease : An individual patient data meta-analysis', Psychosomatic Medicine, vol. 85, no. 2, pp. 188-202. https://doi.org/10.1097/PSY.0000000000001164