Tags

Type your tag names separated by a space and hit enter

Adverse clinical events in patients treated with sirolimus-eluting stents: the impact of Type D personality.
Eur J Cardiovasc Prev Rehabil. 2007 Feb; 14(1):135-40.EJ

Abstract

BACKGROUND

Little is known about the impact of psychological risk factors on cardiac prognosis in the drug-eluting stent era. We examined whether the distressed personality (Type D) moderates the effect of percutaneous coronary intervention with sirolimus-eluting stent implantation on adverse clinical events at 2-year follow-up. Type D is an emerging risk factor in patients with cardiovascular disease.

DESIGN

Prospective follow-up study.

METHODS

Three hundred and fifty-eight patients with ischemic heart disease, who consecutively underwent percutaneous coronary intervention with sirolimus-eluting stent as part of the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital registry, completed the Type D Scale (DS14) post-percutaneous coronary intervention (PCI). The end-point was a composite of death and non-fatal myocardial infarction 2 years after PCI.

RESULTS

At follow-up, there were 22 events (12 deaths and 11 myocardial infarctions). Type D patients had a greater than two-fold risk of an event at follow-up compared with non-Type D patients (10.4 vs. 4.4%, P=0.031). In multivariable analysis, Type D remained an independent predictor of adverse outcome (hazard ratio: 2.61; 95% confidence interval: 1.12-6.09; P=0.027) adjusting for sex, age, and history of coronary artery disease, multivessel disease, diabetes, hypercholesterolemia, hypertension, renal impairment and smoking. Previous cardiac history was also an independent predictor of death or myocardial infarction (hazard ratio: 2.83; 95% confidence interval: 1.00-7.96; P=0.049).

CONCLUSIONS

Type D personality moderated the effect of percutaneous coronary intervention on hard clinical events despite treatment with the latest innovation in interventional cardiology. The inclusion of psychological risk factors in general and personality factors in particular may optimize risk stratification in the drug-eluting stent era.

Authors+Show Affiliations

Department of Cardiology, Thoraxcentre, Erasmus Medical Centre Rotterdam, The Netherlands. s.s.pedersen@uvt.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17301639

Citation

Pedersen, Susanne S., et al. "Adverse Clinical Events in Patients Treated With Sirolimus-eluting Stents: the Impact of Type D Personality." European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups On Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, vol. 14, no. 1, 2007, pp. 135-40.
Pedersen SS, Denollet J, Ong AT, et al. Adverse clinical events in patients treated with sirolimus-eluting stents: the impact of Type D personality. Eur J Cardiovasc Prev Rehabil. 2007;14(1):135-40.
Pedersen, S. S., Denollet, J., Ong, A. T., Sonnenschein, K., Erdman, R. A., Serruys, P. W., & van Domburg, R. T. (2007). Adverse clinical events in patients treated with sirolimus-eluting stents: the impact of Type D personality. European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups On Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology, 14(1), 135-40.
Pedersen SS, et al. Adverse Clinical Events in Patients Treated With Sirolimus-eluting Stents: the Impact of Type D Personality. Eur J Cardiovasc Prev Rehabil. 2007;14(1):135-40. PubMed PMID: 17301639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adverse clinical events in patients treated with sirolimus-eluting stents: the impact of Type D personality. AU - Pedersen,Susanne S, AU - Denollet,Johan, AU - Ong,Andrew T L, AU - Sonnenschein,Karel, AU - Erdman,Ruud A M, AU - Serruys,Patrick W, AU - van Domburg,Ron T, PY - 2007/2/16/pubmed PY - 2007/5/18/medline PY - 2007/2/16/entrez SP - 135 EP - 40 JF - European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology JO - Eur J Cardiovasc Prev Rehabil VL - 14 IS - 1 N2 - BACKGROUND: Little is known about the impact of psychological risk factors on cardiac prognosis in the drug-eluting stent era. We examined whether the distressed personality (Type D) moderates the effect of percutaneous coronary intervention with sirolimus-eluting stent implantation on adverse clinical events at 2-year follow-up. Type D is an emerging risk factor in patients with cardiovascular disease. DESIGN: Prospective follow-up study. METHODS: Three hundred and fifty-eight patients with ischemic heart disease, who consecutively underwent percutaneous coronary intervention with sirolimus-eluting stent as part of the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital registry, completed the Type D Scale (DS14) post-percutaneous coronary intervention (PCI). The end-point was a composite of death and non-fatal myocardial infarction 2 years after PCI. RESULTS: At follow-up, there were 22 events (12 deaths and 11 myocardial infarctions). Type D patients had a greater than two-fold risk of an event at follow-up compared with non-Type D patients (10.4 vs. 4.4%, P=0.031). In multivariable analysis, Type D remained an independent predictor of adverse outcome (hazard ratio: 2.61; 95% confidence interval: 1.12-6.09; P=0.027) adjusting for sex, age, and history of coronary artery disease, multivessel disease, diabetes, hypercholesterolemia, hypertension, renal impairment and smoking. Previous cardiac history was also an independent predictor of death or myocardial infarction (hazard ratio: 2.83; 95% confidence interval: 1.00-7.96; P=0.049). CONCLUSIONS: Type D personality moderated the effect of percutaneous coronary intervention on hard clinical events despite treatment with the latest innovation in interventional cardiology. The inclusion of psychological risk factors in general and personality factors in particular may optimize risk stratification in the drug-eluting stent era. SN - 1741-8267 UR - https://www.unboundmedicine.com/medline/citation/17301639/Adverse_clinical_events_in_patients_treated_with_sirolimus_eluting_stents:_the_impact_of_Type_D_personality_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=17301639.ui DB - PRIME DP - Unbound Medicine ER -