Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
Negative psychological status is acknowledged as one of risk of development of cardiovascular pathology. However, predictive value of type D personality (psychosocial distress) in different cultures and the countries are not fully understood. Purpose: Study aim was to investigate the association of type D personality and quality of life (QoL) with the development of cardiovascular complication in patients in five years after coronary artery bypass grafting (CABG). Materials and Methods: Evaluation of psychological status and combined risk of nonfatal (strokes, nonfatal myocardial infarctions, repeat procedures of revascularization and hospitalization due to relapse or progression of angina pectoris) and fatal (general and cardiovascular mortality) cases before and in five years after CABG. Patients with chronic ischemic heart disease (n = 602, 112 (18.5%) females and 490 (81.5%) males, mean age = 57.7 ± 7.3 years.) who had had CABG were included in the study. Who were formed in two groups: patients with the presence of type D (n= 134) and patients without type D (n = 468). The study of the psychological status was carried out using questionnaire DS-14. Analysis of long-term results were assessed using the Kaplan–Meier method. Data was collected by a SF-36 questionnaire, comprising of 36 questions divided in 8 domains. The score was designated as 0 to 100; with the higher score being indicative of a better QoL. Results: Frequency of fatal cases in both groups amounted 8.3% and 8.1% (p = 0.145), in turn nonfatal end-points in group with type D amounted 31.8%, and 15.9% in group without type D (p = 0.044) in during the 5 years. Presence of type D personality at initial examination increased 3.21 times combined risk of nonfatal and fatal cases (OR 3.21, 95% CI 2.02-6.14, p = 0.002). In long term period there were no differences in survival between groups type D and without type D (95.5% vs. 96.8%), There were differences in groups type D and without type D in nonfatal events (strokes, nonfatal myocardial infarctions, secondary endpoint: repeat procedures of revascularization and hospitalization due to relapse or progression of angina pectoris) (respectively, 97.1% vs 88.0%, (p = 0.341). Findings showed that 75% of subjects reported well QoL, while the mean score regarding QoL in patients with type D personality, were higher than in patients without type D in all health related dimensions. Based on t-test difference, the of QoL in in patients with type D and in patients without type D for physical health (p < 0.015), mental limitation (p < 0.043), somatic pain (p < 0.022) and mental health (p < 0.041) was observed. Conclusion: Type D patients had a greater risk for nonfatal cardiac events and lower QoL indicators, compared with non Type D patients. Accumulated proofs indicate that in detection of patients at risk of development of stress induced cardiac complications after CABG it is reasonable to use approach which involves consideration of personality type.
Developing a prioritisation framework for patients in need of coronary artery angiography
