title: Type-D personality exerts a stable, adverse effect on vital exhaustion in PCI patients treated with paclitaxel-eluting stents.
abstract: OBJECTIVE
  Vital exhaustion is associated with the pathogenesis of cardiovascular disease (CVD), but its prevalence after percutaneous coronary intervention (PCI) with drug-eluting stent implantation, as well as the impact of personality on exhaustion, is not known. In PCI patients, we examined (a) the prevalence of exhaustion, (b) the impact of type-D personality on exhaustion over time, and (c) the clinical significance of type-D personality compared with gender and age as predictors of exhaustion.
  
  
  METHODS
  Consecutive patients (n=419) with stable or unstable angina treated with PCI with drug-eluting stent implantation completed the Type-D Scale (DS14) at baseline and the Maastricht Questionnaire (which assesses exhaustion) at baseline and at 1 year.
  
  
  RESULTS
  Of all patients, 53% were exhausted at baseline and at 1 year, with 41% experiencing chronic symptoms. Type-D patients [F(1, 417)=98.688; P<.001] had significantly higher exhaustion levels than non type-D patients both at the time of the index PCI and at 1 year. There was a general improvement in symptoms of exhaustion over time [F(1, 417)=5.005; P=.03], but type-D exerted a stable effect on exhaustion (P=.06). In multivariable analysis, type-D (OR=3.53; 95% CI=1.88-6.64) remained an independent predictor of exhaustion at 1 year, adjusting for demographic and clinical risk factors and exhaustion at baseline. The impact of type-D on exhaustion was large compared with a small effect for gender and age, as measured by Cohen's effect size index.
  
  
  CONCLUSIONS
  Symptoms of exhaustion were still highly prevalent in PCI patients 1 year post-PCI despite treatment with the latest technique in interventional cardiology. Type-D exerted a large and stable effect on exhaustion compared with that of gender and age. CVD research and clinical practice may benefit by adopting a personality approach in order to identify high-risk patients.
authors: CoRPS-Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands. s.s.pedersen@uvt.nl
authors: Susanne S
authors: SS
authors: Pedersen
authors: Joost
authors: J
authors: Daemen
authors: Meike
authors: M
authors: van de Sande
authors: Karel
authors: K
authors: Sonnenschein
authors: Patrick W
authors: PW
authors: Serruys
authors: Ruud A M
authors: RA
authors: Erdman
authors: Ron T
authors: RT
authors: van Domburg
mesh_terms: D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000523:psychology* / Q000628:therapy*; D000789:Angina, Unstable / Q000523:psychology* / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000523:psychology*; D020099:Coated Materials, Biocompatible; D005221:Fatigue / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D010555:Personality Inventory; D012307:Risk Factors; D012737:Sex Factors; D015607:Stents
chemical_list: D020099:Coated Materials, Biocompatible; D017239:Paclitaxel