Lack of prognostic value of type D personality for mortality in a large sample of heart failure patients

James C Coyne, Tiny Jaarsma, Marie-Louise Luttik, Eric van Sonderen, Dirk J van Veldhuisen, Robbert Sanderman

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND: Type D personality has been proposed as a prognostic indicator for mortality in cardiovascular disease. Most research examining this construct originates from one research group, and it is critical that the predictive value of Type D personality for adverse outcomes is independently cross-validated. This study examined its prognostic value in heart failure, relative to B-type natriuretic peptide (BNP) and depressive symptoms.

METHODS: We studied 706 patients with complete BNP, depressive symptom, and Type D personality and mortality data from 958 patients with heart failure enrolled after hospitalization for a multisite study of a disease management program. Multivariable models were adjusted for BNP and depression.

RESULTS: At 18 months, there were 192 deaths (27.2%). No evidence was found for a prognostic value of Type D personality in the unadjusted model (hazard ratio [HR] = 0.893, 95% confidence interval [CI] = 0.582-1.370). In contrast, BNP was significantly predictive of mortality (HR = 1.588, 95% CI = 1.391-1.812), whereas depression was not (HR = 1.011, 95% CI = 0.998-1.024). Type D was also not predictive in covariate-adjusted models (HR = 0.779, 95% CI = 0.489-1.242). Similar results were obtained when analyzing Type D as the interaction between continuous z scores of its two components, negative affectivity and social inhibition (p = .144).

CONCLUSIONS: In the largest study to date, Type D does not predict mortality. Future research should construe Type D as the interaction of continuous negative affectivity and social inhibition z scores, rather than as a typology, and consider analyses replacing negative affectivity with depression.

Original languageEnglish
Pages (from-to)557-562
JournalPsychosomatic medicine
Volume73
Issue number7
DOIs
Publication statusPublished - Sep 2011
Externally publishedYes

Keywords

  • depressions
  • heart failures
  • natriuretic peptides
  • personality
  • prognosis
  • psychiatric status rating scales

Cite this

Coyne, James C ; Jaarsma, Tiny ; Luttik, Marie-Louise ; van Sonderen, Eric ; van Veldhuisen, Dirk J ; Sanderman, Robbert. / Lack of prognostic value of type D personality for mortality in a large sample of heart failure patients. In: Psychosomatic medicine. 2011 ; Vol. 73, No. 7. pp. 557-562.
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abstract = "BACKGROUND: Type D personality has been proposed as a prognostic indicator for mortality in cardiovascular disease. Most research examining this construct originates from one research group, and it is critical that the predictive value of Type D personality for adverse outcomes is independently cross-validated. This study examined its prognostic value in heart failure, relative to B-type natriuretic peptide (BNP) and depressive symptoms.METHODS: We studied 706 patients with complete BNP, depressive symptom, and Type D personality and mortality data from 958 patients with heart failure enrolled after hospitalization for a multisite study of a disease management program. Multivariable models were adjusted for BNP and depression.RESULTS: At 18 months, there were 192 deaths (27.2{\%}). No evidence was found for a prognostic value of Type D personality in the unadjusted model (hazard ratio [HR] = 0.893, 95{\%} confidence interval [CI] = 0.582-1.370). In contrast, BNP was significantly predictive of mortality (HR = 1.588, 95{\%} CI = 1.391-1.812), whereas depression was not (HR = 1.011, 95{\%} CI = 0.998-1.024). Type D was also not predictive in covariate-adjusted models (HR = 0.779, 95{\%} CI = 0.489-1.242). Similar results were obtained when analyzing Type D as the interaction between continuous z scores of its two components, negative affectivity and social inhibition (p = .144).CONCLUSIONS: In the largest study to date, Type D does not predict mortality. Future research should construe Type D as the interaction of continuous negative affectivity and social inhibition z scores, rather than as a typology, and consider analyses replacing negative affectivity with depression.",
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Lack of prognostic value of type D personality for mortality in a large sample of heart failure patients. / Coyne, James C; Jaarsma, Tiny; Luttik, Marie-Louise; van Sonderen, Eric; van Veldhuisen, Dirk J; Sanderman, Robbert.

In: Psychosomatic medicine, Vol. 73, No. 7, 09.2011, p. 557-562.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Lack of prognostic value of type D personality for mortality in a large sample of heart failure patients

AU - Coyne, James C

AU - Jaarsma, Tiny

AU - Luttik, Marie-Louise

AU - van Sonderen, Eric

AU - van Veldhuisen, Dirk J

AU - Sanderman, Robbert

PY - 2011/9

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N2 - BACKGROUND: Type D personality has been proposed as a prognostic indicator for mortality in cardiovascular disease. Most research examining this construct originates from one research group, and it is critical that the predictive value of Type D personality for adverse outcomes is independently cross-validated. This study examined its prognostic value in heart failure, relative to B-type natriuretic peptide (BNP) and depressive symptoms.METHODS: We studied 706 patients with complete BNP, depressive symptom, and Type D personality and mortality data from 958 patients with heart failure enrolled after hospitalization for a multisite study of a disease management program. Multivariable models were adjusted for BNP and depression.RESULTS: At 18 months, there were 192 deaths (27.2%). No evidence was found for a prognostic value of Type D personality in the unadjusted model (hazard ratio [HR] = 0.893, 95% confidence interval [CI] = 0.582-1.370). In contrast, BNP was significantly predictive of mortality (HR = 1.588, 95% CI = 1.391-1.812), whereas depression was not (HR = 1.011, 95% CI = 0.998-1.024). Type D was also not predictive in covariate-adjusted models (HR = 0.779, 95% CI = 0.489-1.242). Similar results were obtained when analyzing Type D as the interaction between continuous z scores of its two components, negative affectivity and social inhibition (p = .144).CONCLUSIONS: In the largest study to date, Type D does not predict mortality. Future research should construe Type D as the interaction of continuous negative affectivity and social inhibition z scores, rather than as a typology, and consider analyses replacing negative affectivity with depression.

AB - BACKGROUND: Type D personality has been proposed as a prognostic indicator for mortality in cardiovascular disease. Most research examining this construct originates from one research group, and it is critical that the predictive value of Type D personality for adverse outcomes is independently cross-validated. This study examined its prognostic value in heart failure, relative to B-type natriuretic peptide (BNP) and depressive symptoms.METHODS: We studied 706 patients with complete BNP, depressive symptom, and Type D personality and mortality data from 958 patients with heart failure enrolled after hospitalization for a multisite study of a disease management program. Multivariable models were adjusted for BNP and depression.RESULTS: At 18 months, there were 192 deaths (27.2%). No evidence was found for a prognostic value of Type D personality in the unadjusted model (hazard ratio [HR] = 0.893, 95% confidence interval [CI] = 0.582-1.370). In contrast, BNP was significantly predictive of mortality (HR = 1.588, 95% CI = 1.391-1.812), whereas depression was not (HR = 1.011, 95% CI = 0.998-1.024). Type D was also not predictive in covariate-adjusted models (HR = 0.779, 95% CI = 0.489-1.242). Similar results were obtained when analyzing Type D as the interaction between continuous z scores of its two components, negative affectivity and social inhibition (p = .144).CONCLUSIONS: In the largest study to date, Type D does not predict mortality. Future research should construe Type D as the interaction of continuous negative affectivity and social inhibition z scores, rather than as a typology, and consider analyses replacing negative affectivity with depression.

KW - depressions

KW - heart failures

KW - natriuretic peptides

KW - personality

KW - prognosis

KW - psychiatric status rating scales

KW - depressies

KW - hartfalen

U2 - 10.1097/PSY.0b013e318227ac75

DO - 10.1097/PSY.0b013e318227ac75

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SP - 557

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JO - Psychosomatic medicine

JF - Psychosomatic medicine

SN - 0033-3174

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