Coronary calcinosis and psychological distress association, by the data from ESSE-RF study in Kemerovskaya Region

Abstract

Aim. To evaluate the association of coronary arteries calcinosis with personality type D, by ESSE-RF (Epidemiology of cardiovascular diseases and risk factors in various regions of Russian Federation) trial data in Kemerovskaya Oblast.Material and methods. The study has been done under the framework of ESSE-RF trial. Standard protocol was updated with personality type assessment by DS-14 questionnaire. All patients underwent quantitative assessment of coronary calcinosis with multispiral computed tomography. The data package was analyzed with Agatstone method. Two groups of patients collected: group 1 (n=231) with type D personality, and group 2 with non-D (n=1379).Results. With the evaluation of calcium index (CaI) there were significant differences in groups: 689,3+53,7 in type D patients and 546,5+47 with none (p=0,048). Moderate and severe CaI was higher in type D patients — 10,3% and 12,5% vs 5,8% and 2,9%, respectively (p=0,043 and p=0,011). Highest differences in CaI in the left coronary artery, exactly in the left anterior descending, were 189,1+12,5 in type D vs 155,6+16,7 in non-type D (p=0,011), and circumflex artery — 121,7+30,6 vs 63,8+21,7 (p=0,032). With the logistic regression, the most influencing on moderate and severe CaI were age — hazard ratio (HR) 1,07-2,14 (p=0,023), diabetes — HR 1,32; 95% CI 1,09-1,62 (p=0,032), type D personality — HR 1,42; 95% CI 1,12-1,82 (p=0,023), coronary heart disease — HR 1,12; 95% CI 1,01-1,21 (p=0,034). By the multifactorial analysis, as independent predictors of moderate and severe CI remained such parameters as coronary heart disease — HR 1,24 95% CI 1,01-1,53 (р=0,04), diabetes — HR 1,28; 95% CI 1,80-3,24 (р=0,02) and type D — HR 1,49; 95% CI 2,01-2,29 (р=0,01).Conclusion. Screening for the influence of type D personality is worthy in persons with subclinical coronary arteries lesion to conduct on-time preventive events.

Is the concept of type D personality a component of personalized medicine or a prognostic factor in the treatment of cardiovascular diseases?

“…Об этом же могут свидетельствовать данные проведенных исследований о более частом выявлении у больных с типом личности Д различных коморбидных состояний, ассоциированных с неблагоприятным прогнозом. Так, при типе личности Д у больных стабильной ИБС перед коронарным шунтированием более часто выявляли мультифокальный атеросклероз [46], а в когорте исследования ЭССЕ-РФ в Кемеровской области с типом личности Д было ассоциировано более частое выявление кальциноза коронарных артерий [47] и метаболического синдрома [48]. Наряду с подтверждением для российской популяции ассоциации типа личности Д с низкой физической активностью [49] и низкой приверженностью к медикаментозной терапии [50], это может дополнительно служить объяснением неблагоприятного влияния типа личности Д на прогноз.…”