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Mommersteeg, P M C, Lodder, P & Widdershoven, J 2024, 'Type D personality, psychosocial factors, and health status as predictors for major adverse cardiovascular events in nonobstructive coronary artery disease.', Psychosomatic Medicine, vol. 86, no. 5, pp. A146-A147. |
| Description: |
Patients with non-obstructive coronary artery disease (NOCAD) are at risk for major adverse cardiovascular events (MACE). We aimed to examine whether Type D (distressed) personality, depressive symptoms, anxiety, positive mood, hostility, and fatigue and health status pose a risk for MACE in patients with NOCAD. More psychological distress and worse health status are hypothesized to be related to a higher risk for MACE, for which sex differences may be present. After a 9.5-year follow-up period MACE was examined in 546 patients with NOCAD as part of the Tweesteden Mild Stenosis (TWIST) study. MACE included cardiac mortality, a major cardiac event, or (when absent) all cause mortality. Cox proportional hazard models were used to examine the impact of the psychosocial factors and health status on MACE while adjusting for age, sex, disease severity, and lifestyle covariates. Potential sex differences were explored. In total 19% of the patients (Inclusion mean age 61, SD 9 years; 52% women) experienced MACE, with an annualized event rate (AER) for MACE of 20 events per 1,000 personyears, and a lower risk for women compared to men. In covariate adjusted models positive mood (HR 0.97, 95%CI 0.95-1.00), fatigue (HR 1.03, 95%CI 1.00-1.06), and physical limitation (HR 0.99, 95%CI 0.98-1.00) remained significantly associated with MACE. This risk was more pronounced in men than in women, though no significant interactions between sex and psychosocial factors were present. Depressive symptoms were predictive of MACE in the age and sex adjusted model, but no longer after further adjustment for confounders including disease severity and lifestyle factors. Noticeable is that Type D personality, anxiety, hostility, mental health status, and angina frequency and stability were not significantly associated with MACE in this patient group. In patients with NOCAD Type D personality, psychosocial factors, and health status were not predictive of adverse outcomes. Fatigue, low positive mood, and a lower physical limitation score were ... |