title: Impaired health status in Type D patients following PCI in the drug-eluting stent era.
abstract: BACKGROUND
  Drug-eluting stenting reduces restenosis post-percutaneous coronary intervention (PCI), but subgroups of patients may not benefit optimally from this procedure. We examined the impact of Type D personality on health status over time and the clinical relevance of Type D as a predictor of impaired health status at 12 months in unselected post-PCI patients.
  
  
  METHODS
  Consecutive patients (n=692) participating in the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry completed the Type D Scale at 6 months and the Short Form Health Survey 36 (SF-36) at 6 and 12 months post-PCI.
  
  
  RESULTS
  Although there was a significant improvement in health status over time (p<0.001), Type D patients reported a substantially lower score on all health status domains of the SF-36 compared with non-Type D patients (p<0.001). Type D personality was an independent predictor of impaired health status on all SF-36 sub domains at 12 months except for physical functioning, adjusting for baseline demographic and clinical variables and health status at 6 months. In these adjusted analyses, Type D personality increased the likelihood of impaired health status at 12 months post-PCI from 60% (OR: 1.60; 95% CI: 1.04-2.46) to almost 300% (OR: 3.99; 95% CI: 2.52-6.32), varying among the parameters analyzed.
  
  
  CONCLUSIONS
  Type D personality was associated with impaired health status in post-PCI patients treated in the drug-eluting stent era. The role of personality factors as determinants of clinical outcome and health status should not be overlooked as these factors may have much explanatory power.
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: Johan
authors.initials: J
authors.lastname: Denollet
authors.forename: Andrew T L
authors.initials: AT
authors.lastname: Ong
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Ruud A M
authors.initials: RA
authors.lastname: Erdman
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000517:prevention & control* / Q000523:psychology*; D016503:Drug Delivery Systems; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D010551:Personality / Q000145:classification*; D010555:Personality Inventory; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents