Symptoms of fatigue and depression in ischemic heart disease are driven by personality characteristics rather than disease stage: a comparison of CAD and CHF patients

Background Symptoms of fatigue and depression are prevalent across stages of ischemic heart disease (IHD). We examined (I) the effect of both the MID stage and type-D personality on fatigue and depressive symptoms at 12-month follow-up, and 00 whether the effect of type-D personality on these symptoms is moderated by IHD stage. Methods Two different samples of patients were included to represent IHD stage: 401 percutaneous coronary intervention patients (early-stage IHD) and 105 ischemic chronic heart failure patients (end-stage IHD) completed the DS14 Type-D Scale at baseline. Logistic regression analysis was used to examine the impact of IHD stage and type-D personality on fatigue and depression at follow-up. Results Disease stage was neither associated with symptoms of fatigue (P=0.99) nor depression (P=0.29) at 12 months. In contrast, type-D personality was shown to predict both symptoms of fatigue [odds ratio (OR) = 2.96; 95% confidence interval (Cl): 1.92-4.58, P<0.001] and depression (OR = 4.91; 95% Cl: 3.16-7.65, P<0.001) at follow-up; the effect of type-D personality on these symptoms was not moderated by disease stage. In multivariable analysis, type-D remained a significant predictor of symptoms of fatigue (OR = 3.14; 95% Cl: 1.98-4.99, P<0.001) and depression (OR = 5.90; 95% Cl: 3.60-9.67, P<0.001), also after controlling for symptom levels at baseline. Conclusion Type-D personality but not disease stage predicted symptoms of fatigue and depression at 12-month follow-up. Eur J Cardiovasc Prev Rehabil 15:583-588 (C) 2008 The European Society of Cardiology