Impaired health status in Type D patients following PCI in the drug-eluting stent era.
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.
Pedersen
Susanne S
SS
Department of Cardiology, Thoraxcenter, Erasmus Medical Center Rotterdam, The Netherlands. s.s.pedersen@uvt.nl
Denollet
Johan
J
Ong
Andrew T L
AT
Serruys
Patrick W
PW
Erdman
Ruud A M
RA
van Domburg
Ron T
RT
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