Prognostic value of type D personality for 10-year mortality and subjective health status in patients treated with percutaneous coronary intervention

Objective: Given the debate around limitations and controversies in type D personality studies, we aimed to evaluate the prognostic value of 'synergistically' analyzed type D personality (interaction z-scores negative affectivity NA, and social inhibition SI) on 10-year mortality and on 10-year subjective health status in percutaneous coronary intervention (PCI) patients. Methods: This prospective study comprised a cohort of 1190 consecutive patients who underwent PCI between October 2001 and September 2002 (73% male, mean age: 62 years, range [27-90] years). At baseline, type D personality (DS14), and depression/anxiety (HADS) were assessed. Primary endpoint was 10 year all-cause mortality; secondary endpoint was 10-year subjective health status (SF-36). Results: After a median follow-up of 103 years (IQR 9.8-10.8), 293 deaths of any cause (24.6%) were recorded. After adjustment for significant baseline characteristics, personality categories approached and dichotomously approached type D personality were associated with 10-year mortality, p < .05. Synergistically approached type D personality was not associated with all-cause mortality or subjective health status at 10 years. In survivors, higher NA was associated with lower subjective health status. Type D was not associated with mortality after adjusting for continuous depression and anxiety in all approaches. Conclusions: Synergistically analyzed type D was not associated with 10-year all-cause mortality in PCI patients whereas dichotomous type D was. However, after adjustment for depression most of the findings had disappeared. Depression played an important role in this. Type D was not associated with 10-year subjective health status. (C) 2015 Elsevier Inc. All rights reserved.