title: Type D personality and cardiac mortality in patients with chronic heart failure.
abstract: BACKGROUND
  Clinical predictors of cardiac mortality in chronic heart failure (CHF) are established, but less is known about chronic psychological predictors. Therefore, we examined the prognostic value of Type D personality (tendency to experience negative feelings and inhibit self-expression) in CHF patients.
  
  
  RESULTS
  Consecutive systolic CHF outpatients (n=232) filled in the Type D Scale (DS14) at baseline. Socio-demographic and clinical data were obtained from the medical record/cardiologist. The primary endpoint was total cardiac mortality (follow-up=30.7+/-11.1 months). Late (>6 months) cardiac mortality was the secondary endpoint. Type D patients had a higher incidence of total cardiac mortality (15/48=31.3%) as compared to non Type D patients (32/184=17.4%), OR=2.16;95%CI:1.05-4.43, p=.04. Type D personality was a near significant independent predictor of total cardiac mortality (OR=1.40;95%CI:0.93-4.29, p=.08), and a significant independent predictor of late cardiac mortality, adjusting for sex, age and left ventricular ejection fraction (OR=2.34;95%CI:1.05-5.26, p=.04).
  
  
  CONCLUSIONS
  Type D personality was a near-significant independent predictor of total cardiac mortality, and a significant independent predictor of late cardiac mortality, adjusting for socio-demographics and disease-severity. These findings suggest that Type D personality, a chronic psychological risk factor, is of importance in long-term prognosis in CHF.
authors.affiliation: Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, the Netherlands.
authors.forename: Angélique A
authors.initials: AA
authors.lastname: Schiffer
authors.forename: Otto R F
authors.initials: OR
authors.lastname: Smith
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: Jos W
authors.initials: JW
authors.lastname: Widdershoven
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
mesh_terms: D000368:Aged; D002908:Chronic Disease; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality* / Q000523:psychology*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009341:Negativism; D010551:Personality; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors