title: Type-D personality predicts chronic anxiety following percutaneous coronary intervention in the drug-eluting stent era.
abstract: BACKGROUND
  Anxiety is an often overlooked risk factor in coronary artery disease (CAD). Hence, little is known about predictors of unremitting chronic anxiety in CAD patients. We examined whether the distressed personality (type-D) predicts chronic anxiety post percutaneous coronary intervention (PCI).
  
  
  METHODS
  Unselected patients (n=167) treated with PCI using sirolimus-eluting or bare metal stents as part of the RESEARCH registry, who were anxious 6 months post-PCI, qualified for inclusion. Patients completed the Hospital Anxiety and Depression Scale at 6 and 12 months and the Type-D Scale (DS14) 6 months post-PCI.
  
  
  RESULTS
  Of 167 patients anxious at 6 months, 108 (65%) were still anxious 12 months post-PCI. Significant univariable predictors of chronic anxiety were type-D personality (OR: 3.17; 95% CI: 1.64-6.14) and sirolimus-eluting stent implantation (OR: 0.51; 95% CI: 0.27-0.98), with sirolimus-eluting stent showing a protective effect. In multivariable analyses, type-D personality (OR: 3.31; 95% CI: 1.59-6.87) and sirolimus-eluting stent implantation (OR: 0.44; 95% CI: 0.21-0.92) remained significant independent predictors of chronic anxiety adjusting for depressive symptoms at 6 months, demographic and clinical risk factors.
  
  
  CONCLUSIONS
  All psychological measures were based on self-report, and we had no information on cardiac rehabilitation or use of pharmacotherapy; however our sample represented patients seen in daily clinical practice.
  
  
  CONCLUSIONS
  These findings suggest that type-D personality is a risk factor and sirolimus-eluting stent implantation a protective factor for the occurrence of chronic anxiety. The protective effect of sirolimus-eluting stents in relation to anxiety warrants replication in future studies.
authors.affiliation: Department of Psychology, Aarhus University, Denmark.
authors.forename: Helle
authors.initials: H
authors.lastname: Spindler
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
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: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D020099:Coated Materials, Biocompatible; D003327:Coronary Disease / Q000523:psychology* / Q000628:therapy; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000628:therapy; D010555:Personality Inventory; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D014434:Type A Personality
chemical_list: D020099:Coated Materials, Biocompatible; D007166:Immunosuppressive Agents; D020123:Sirolimus