title: Association between type D personality and prognosis in patients with cardiovascular diseases: a systematic review and meta-analysis.
abstract: BACKGROUND
  Since 1995, the association of type D personality and mortality in patients with cardiovascular diseases has been increasingly investigated.
  
  
  OBJECTIVE
  The aim of this meta-analysis was to integrate conflicting results and to examine possible moderators of this association.
  
  
  METHODS
  Prospective studies assessing type D personality and hard endpoints were selected and pooled in meta-analyses. Cardiovascular diagnosis, type and quality of adjustment, and publication date were examined in moderator analyses.
  
  
  RESULTS
  Twelve studies on patients with cardiovascular diseases (N = 5,341) were included. Pooled crude and adjusted effects demonstrated a significant association of type D personality and hard endpoints (odds ratio (OR) of 2.28 (95% CI [1.43-3.62]), adjusted hazard ratio (HR) of 2.24 (95% CI [1.37-3.66])). The OR decreased over time (OR 5.02 to OR 1.54). There was no association in congestive heart failure patients.
  
  
  CONCLUSIONS
  More recent methodologically sound studies suggest that early type D studies had overestimated the prognostic relevance.
authors.affiliation: Faculty of Applied Social Sciences, Leipzig University of Applied Sciences, Germany. grande@fas.htwk-leipzig.de
authors.forename: Gesine
authors.initials: G
authors.lastname: Grande
authors.forename: Matthias
authors.initials: M
authors.lastname: Romppel
authors.forename: Jürgen
authors.initials: J
authors.lastname: Barth
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D006801:Humans; D010551:Personality; D011379:Prognosis