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Association between Type D personality and outcomes in patients with non-ischemic heart failure

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Abstract

Purpose

The “distressed” (Type D) personality trait has been reported to be over-represented in patients with heart failure (HF) compared to the background population and may provide prognostic information for mortality. We examined the association between Type D personality and outcomes in the DANISH trial (The Danish Study to Assess the Efficacy of Implantable Cardioverter Defibrillators in Patients with Non-ischemic Systolic Heart Failure on Mortality).

Methods

The DANISH trial included a total of 1116 patients with non-ischemic HF on guideline-recommended therapy. Type D personality was assessed with the Type D Scale (DS14) at baseline and investigated through follow-up accordingly. Multivariable Cox proportional hazard models were used to compare hazard ratios (HR) of cardiovascular and all-cause mortality.

Results

Type D personality assessment was completed by 873 (78%) patients at baseline and Type D personality was found in 120 (14%) patients. The median follow-up was 67 months (interquartile range [IQR] 48–83). Among patients with versus without Type D personality, 22% versus 19% died from all-cause yielding similar incidence rates of 4.62 (95% CI 3.14–6.87) versus 3.95 (95% CI 3.37–4.66) per 100 person-years. The adjusted risk of all-cause mortality was not significantly different in patients with versus without Type D personality with an adjusted HR of 1.31 (95% CI 0.84–2.03, p = 0.23) with similar results for cardiovascular death (HR 1.46 (95% CI 0.88–2.44, p = 0.15).

Conclusion

Type D personality was not significantly associated with increased risk of all-cause mortality or cardiovascular death in patients with non-ischemic HF.

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Acknowledgements

This study is a substudy of DANISH trial, which was supported by unrestricted grants from Medtronic, St. Jude Medical, Trygfonden, and the Danish Heart Foundation.

Funding

This study was supported by the Independent Research Fund Denmark [7090-00032B].

Author information

Authors and Affiliations

  1. Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Johan S. Bundgaard, Lauge Østergaard, Jens J. Thune, Lars Køber & Ulrik M. Mogensen

  2. Department of Cardiovascular Epidemiology and Research, The Danish Heart Foundation, Copenhagen, Denmark

    Gunnar Gislason

  3. Department of Clinical Epidemiology and Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark

    Anna M. Thøgersen & Christian Torp-Pedersen

  4. Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

    Jens C. Nielsen

  5. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark

    Gunnar Gislason & Jens Haarbo

  6. Department of Cardiology, Odense University Hospital, Odense, Denmark

    Lars Videbæk & Susanne S. Pedersen

  7. Department of Cardiology, Zealand University Hospital, Roskilde, Denmark

    Line L. Olesen

  8. Department of Psychology, University of Southern Denmark, Odense, Denmark

    Susanne S. Pedersen

  9. Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark

    Jens J. Thune

Authors
  1. Johan S. Bundgaard
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  2. Lauge Østergaard
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Corresponding author

Correspondence to Johan S. Bundgaard.

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Conflict of interest

JCN is supported by a grant from the Novo Nordisk Foundation (NNF16OC0018658). CTP reports support for clinical studies from Bayer in the field of protection against thrombosis. LK receives personal fees from Novartis.

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Bundgaard, J.S., Østergaard, L., Gislason, G. et al. Association between Type D personality and outcomes in patients with non-ischemic heart failure. Qual Life Res 28, 2901–2908 (2019). https://doi.org/10.1007/s11136-019-02241-6

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