Type D personality predicts death or myocardial infarction after bare metal stent or sirolimus-eluting stent implantation: a Rapamycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital (RESEARCH) registry substudy.
OBJECTIVE
We investigated the effect of Type D personality on the occurrence of adverse events at nine months in patients with ischemic heart disease (IHD) after percutaneous coronary intervention (PCI) with sirolimus-eluting stents (SESs) or bare stents. Type D patients experience increased negative emotions and tend not to express these emotions in social interactions.


BACKGROUND
The SES is a new advent in interventional cardiology that reduces the restenosis rate and the risk of a major adverse cardiac event, but the SES has not been shown to confer any benefits on death or myocardial infarction (MI).


METHODS
Consecutive patients with IHD (n = 875) enrolled in the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry completed the Type D Personality Scale (DS14) six months after PCI. The end point was a composite of death and MI. Events occurring before administration of the DS14 were excluded from analyses.


RESULTS
At nine months' follow-up, there were 20 events. Type D patients were at a cumulative increased risk of adverse outcome compared with non-Type D patients: 5.6% versus 1.3% (p < 0.002). Type D personality (odds ratio [OR] 5.31; 95% confidence interval [CI] 2.06 to 13.66) remained an independent predictor of adverse outcome adjusting for all other variables, including SES versus bare-stent implantation.


CONCLUSIONS
Type D personality was an independent predictor of adverse events in patients optimally treated with the latest advent in interventional cardiology. The DS14 could be used as a screening instrument in routine clinical practice to optimize risk stratification in IHD patients.
Pedersen
Susanne S
SS
Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. s.s.pedersen@uvt.nl
Lemos
Pedro A
PA
van Vooren
Priya R
PR
Liu
Tommy K K
TK
Daemen
Joost
J
Erdman
Ruud A M
RA
Smits
Pieter C
PC
Serruys
Patrick W J C
PW
van Domburg
Ron T
RT
D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality / Q000523:psychology* / Q000628:therapy*; D010551:Personality; D011379:Prognosis; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents; D016019:Survival Analysis
D007166:Immunosuppressive Agents; D020123:Sirolimus