title: 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.
abstract: 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.
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. s.s.pedersen@uvt.nl
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Lemos
authors.forename: Priya R
authors.initials: PR
authors.lastname: van Vooren
authors.forename: Tommy K K
authors.initials: TK
authors.lastname: Liu
authors.forename: Joost
authors.initials: J
authors.lastname: Daemen
authors.forename: Ruud A M
authors.initials: RA
authors.lastname: Erdman
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Smits
authors.forename: Patrick W J C
authors.initials: PW
authors.lastname: Serruys
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus