Background: Drug-eluting stenting reduces restenosis post-percutaneous coronary intervention (PCI), but subgroups of patients may not benefit optimally from this procedure. We examined the impact of Type D personality on health status over time and the clinical relevance of Type D as a predictor of impaired health status at 12 months in unselected post-PCI patients. Methods: Consecutive patients (n = 692) participating in the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry completed the Type D Scale at 6 months and the Short Form Health Survey 36 (SF-36) at 6 and 12 months post-PCI. Results: Although there was a significant improvement in health status over time (p < 0.001), Type D patients reported a substantially lower score on all health status domains of the SF-36 compared with non-Type D patients (p < 0.001). Type D personality was an independent predictor of impaired health status on all SF-36 sub domains at 12 months except for physical functioning, adjusting for baseline demographic and clinical variables and health status at 6 months. In these adjusted analyses, Type D personality increased the likelihood of impaired health status at 12 months post-PCI from 60% (OR: 1.60; 95% CI: 1.04-2.46) to almost 300% (OR: 3.99; 95% CI: 2.52-6.32), varying among the parameters analyzed. Conclusions: Type D personality was associated with impaired health status in post-PCI patients treated in the drug-eluting stent era. The role of personality factors as determinants of clinical outcome and health status should not be overlooked as these factors may have much explanatory power.

Coronary artery disease, Drug-eluting stent, Health status, Revascularization, Type D personality,
International Journal of Cardiology
Erasmus MC: University Medical Center Rotterdam

Pedersen, S.S, Denollet, J, Ong, A.T.L, Serruys, P.W.J.C, Erdman, R.A.M, & van Domburg, R.T. (2007). Impaired health status in Type D patients following PCI in the drug-eluting stent era. International Journal of Cardiology, 114(3), 358–365. doi:10.1016/j.ijcard.2005.12.018