The Influence of Personality Type D on Cardiovascular Prognosis in Patients After Coronary Artery Bypass Grafting: Data from a 5-Year-Follow-up Study

Background: Type D personality is accompanied by a set of negative behavioral patterns: low physical activity, high levels of psychological distress, low adherence to treatment. However, studies regarding predictive value of the type D personality remain inconclusive: the results varied depending on the examined cohort, age, and ethnicity. The aim of the study was to evaluate the influence of type D personality on the 5-year prognosis in patients undergoing coronary artery bypass grafting (CABG) in Russian population.

Methods: The study included 602 patients with stable coronary artery disease (490 males, 57.7 ± 7.3 years) who had received CABG and were divided into two groups: patients with type D personality (n = 134) and patients without type D (n = 468). The risk of fatal and nonfatal events within 5 years after CABG was assessed.

Results: There was no difference in total mortality in patients with type D and without type D (7.9% and 7.7%, respectively) over the 5-year period. The absence of cardiac events was detected much less frequently in patients with type D (28%) compared with patients without type D (82%; p = 0.021). Multivariate analysis found independent association between the unfavorable outcome and presence of diabetes mellitus (p = 0.021), type D personality (p = 0.039), and multifocal atherosclerosis (p = 0.033) regardless of gender, age, previous myocardial infarction, and stroke.

Conclusions: Type D patients had a greater risk for cardiac events over 5 years after CABG compared with non-type D patients. Obtained data indicates that it is reasonable to consider personality type while detecting patients at risk of development of stress induced cardiac complications after CABG.