title: Type-D personality and cortisol in survivors of acute coronary syndrome.
abstract: OBJECTIVE
  To test the hypothesis that Type-D personality is associated with elevated cortisol levels in patients 4 months after an acute coronary syndrome (ACS).
  
  
  METHODS
  Salivary cortisol profiles were measured at home in 70 coronary heart disease patients (Mean age = 60.90 years, SD = 10.7, 17% female) 4 months after hospitalization for ACS. Eight saliva samples were taken over the course of 1 day.
  
  
  RESULTS
  Thirty eight percent of the ACS patients were defined as Type-D. Cortisol profiles showed a typical diurnal pattern, with low levels in the evening, high levels early in the day. Type-D was not related to the cortisol awakening response, but cortisol output the day was higher in Type-D (mean = 4443.3, SD = 2334.1 nmol/l) than non Type-D patients (mean = 3252.0, SD = 1810.2 nmol/l) after adjustment for age, gender, hypertension, Global Registry of Acute Coronary Events risk score, recurrence of cardiac symptoms, previous myocardial infarction, body mass index and concurrent depressed mood (p = .044). Type-D personality accounted for 6% over the variance in cortisol output over the day, after covariates had been taken into account.
  
  
  CONCLUSIONS
  Type-D personality may be associated with prolonged disruption of the hypothalamic-pituitary-adrenal axis function in survivors of acute cardiac events and may contribute to biological responses influencing future cardiac morbidity.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Molloy
authors.forename: Linda
authors.initials: L
authors.lastname: Perkins-Porras
authors.forename: Philip C
authors.initials: PC
authors.lastname: Strike
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000523:psychology*; D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000523:psychology; D002605:Character; D002940:Circadian Rhythm / Q000502:physiology; D003866:Depressive Disorder / Q000097:blood / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D010698:Phobic Disorders / Q000097:blood* / Q000523:psychology*; D011594:Psychometrics; D012008:Recurrence; D012044:Regression Analysis; D012307:Risk Factors; D012463:Saliva / Q000737:chemistry; D012934:Social Isolation
chemical_list: D006854:Hydrocortisone