Inadequate Response to Treatment in Coronary Heart Disease

Abstract

Decreased LVEF, type D personality, and younger age increase the risk of cardiac events; convergence of these factors predicts nonresponse to treatment. Emotionally stressed and younger patients with CHD represent high-risk groups deserving of special study.

Type D personality and hemodynamic reactivity to laboratory stress in women

“…Conventionally, a median split on both scales is used to identify Type D (e.g., Denollet, 1998;Denollet et al, 2000;Pedersen and Middel, 2001), and good internal reliability has been reported (Denollet, 1998). In the present sample, Cronbach's α for the NA and SI scales was .87 and .75, respectively, indicating acceptable internal consistency.…”

“…Studies have linked Type D personality with cardiac and all-cause mortality (e.g., Denollet et al, 1996;Denollet et al, 2000) and increased cardiac morbidity (Denollet and Brutsaert, 1998). Furthermore, the Type D personality has been shown to be a predictor of patient adjustment to disease interventions (e.g., .…”

“…Furthermore, the Type D personality has been shown to be a predictor of patient adjustment to disease interventions (e.g., . While Type D cannot be said to encompass all psychological risk factors involved in coronary heart disease (CHD; Denollet and Van Heck, 2001), its association with negative clinical outcomes appears to be on par with established biomedical risk factors such as smoking, older age, and poor exercise tolerance (e.g., Denollet et al, 1996;Denollet and Brutsaert, 1998;Denollet et al, 2000). …”

Type D Patients Report Poorer Health Status Prior to and After Cardiac Rehabilitation Compared to Non-Type D Patients

“…In the present study, we found a non-significant interaction effect for Type D personality by time, indicating that personality did not moderate the effects of cardiac rehabilitation on health status but exerted a stable effect on health status over time. In a mixed group of cardiac patients attending cardiac rehabilitation, patients with a Type D personality were also shown to report poorer health status, but this study only evaluated health status at one time point [19]. In the current study, patients with a cardiac history prior to the referral event reported impaired health status compared to patients without a cardiac history.…”

“…Type D is defined by the two normal and stable personality traits Negative Affectivity [17] and Social Inhibition [18]. Patients with this personality disposition often feel sad, have a gloomy view of life, and at the same time do not express these emotions in social interactions because of fear of disapproval or rejection by others [19].…”