title: Higher macrophage superoxide anion production in coronary artery disease (CAD) patients with Type D personality.
abstract: Type D personality (Type D) is an independent psychosocial risk factor for poor cardiac prognosis and increased mortality in patients with cardiovascular disease (CVD), but the involved mechanisms are poorly understood. Macrophages play a pivotal role in atherosclerosis, the process underlying coronary artery disease (CAD). We investigated macrophage superoxide anion production in production in CAD patients with and without Type D.
  
  
  
  We studied 20 male CAD patients with Type D (M:66.7±9.9years) and 20 age-matched male CAD patients without Type D (M:67.7±8.5years). Type D was measured using the DS14 questionnaire with the two subscales 'negative affectivity' and 'social inhibition'. We assessed macrophage superoxide anion production using the WST-1 assay. All analyses were controlled for potential confounders. CAD patients with Type D showed higher superoxide anion production compared to CAD patients without Type D (F(1,38)=15.57, p<0.001). Complementary analyses using the Type D subscales 'negative affectivity' and 'social inhibition', and their interaction as continuous measures, showed that both Type D subscales (negative affectivity: (ß=0.48, p=0.002, R(2)=0.227); social inhibition: (ß=0.46, p=0.003, R(2)=0.208)) and their interaction (ß=0.36, p=0.022, R(2)=0.130) were associated with higher WST-1 reduction scores. Results remained significant when controlling for classical CVD risk factors (i.e. body mass index, mean arterial blood pressure), atherosclerosis severity (i.e. intima media thickness, presence of carotid plaques), and psychological factors (depressive symptom severity, chronic stress).
  
  
  
  Our results indicate higher macrophage superoxide anion production in CAD patients with Type D compared to those without Type D. This may suggest a mechanism contributing to increased morbidity and mortality in CAD patients with Type D.
authors.affiliation: Biological and Health Psychology, University of Bern, Bern, Switzerland; Department of Clinical Research, University of Bern, Bern, Switzerland.
authors.forename: Claudia
authors.initials: C
authors.lastname: Zuccarella-Hackl
authors.affiliation: Department of Clinical Research, University of Bern, Bern, Switzerland; Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland; Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.affiliation: Biological and Health Psychology, University of Bern, Bern, Switzerland; Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany.
authors.forename: Livia
authors.initials: L
authors.lastname: Thomas
authors.affiliation: Biological and Health Psychology, University of Bern, Bern, Switzerland.
authors.forename: Peggy
authors.initials: P
authors.lastname: Kuebler
authors.affiliation: Cardiology Clinic, Tiefenauspital, Bern University Hospital, Bern, Switzerland.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Schmid
authors.affiliation: Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.affiliation: Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Mono
authors.affiliation: Department of Clinical Research, University of Bern, Bern, Switzerland.
authors.forename: Robert
authors.initials: R
authors.lastname: Rieben
authors.affiliation: Institute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, and University of Bern, Bern, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Wiest
authors.affiliation: Biological and Health Psychology, University of Bern, Bern, Switzerland; Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany. Electronic address: petra.wirtz@uni-konstanz.de.
authors.forename: Petra H
authors.initials: PH
authors.lastname: Wirtz
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000378:metabolism / Q000523:psychology; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000209:etiology / Q000378:metabolism* / Q000523:psychology*; D003863:Depression / Q000378:metabolism / Q000523:psychology; D006801:Humans; D008264:Macrophages / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013481:Superoxides / Q000378:metabolism*; D064415:Type D Personality
chemical_list: D013481:Superoxides
keywords: CAD; Human macrophages; NADPH oxidase; Superoxide anions; Type D personality