The Potential Mediating Effects of Inflammation on the Association Between Type D Personality and Coronary Plaque Vulnerability in Patients With Coronary Artery Disease: An Optical Coherence Tomography Study. Issue 4 (17th May 2022)

• Record Type: Journal Article
• Authors: Yi, Huijie; Li, Ling; Wang, Yini; Tao, Hui; Yu, Xi; Yu, Bo; Gao, Xueqin; Lin, Ping
• Is Part Of: Psychosomatic medicine. Volume 84:Issue 4(2022)
• Page Start: 468
• Page End: 477
• Publication Date: 2022-05-17
• Subjects: optical coherence tomography -- type D personality -- inflammation -- coronary plaque vulnerability -- ACS = acute coronary syndrome -- CAD = coronary artery disease -- CHF = chronic heart failure -- HPA = hypothalamic-pituitary-adrenal -- hs-CRP = high-sensitivity C-reactive protein -- IL = interleukin -- NA = negative affectivity -- OCT = optical coherence tomography -- SI = social inhibition -- sTNFr-1 = soluble tumor necrosis factor receptors-1 -- sTNFr-2 = soluble tumor necrosis factor receptors-2 -- TCFA = thin-cap fibroatheroma -- TNF-α = tumor necrosis factor α; Medicine, Psychosomatic -- Periodicals; 616.0805
• DOI: 10.1097/PSY.0000000000001068
• Languages: English
• ISSNs: 0033-3174

Abstract

ABSTRACT: Objective: Type D personality involves the interaction between negative affectivity with social inhibition and has been associated with an increased risk of coronary artery disease (CAD) progression and coronary plaque vulnerability. However, the underlying mechanisms in the relationship between type D personality and coronary plaque vulnerability remain indeterminate. The present study examined the potential mediating effects of inflammation biomarkers on the association between type D personality and coronary plaque vulnerability in patients with CAD. Methods: A total of 347 patients (mean [standard deviation] age = 56.6 [11.2] years; 29.3% women) with CAD who had culprit coronary plaques were examined for type D personality. The inflammation biomarkers (high-sensitivity C-reactive protein, interleukin 6 [IL-6], and tumor necrosis factor α [TNF-α]) were evaluated. Each individual inflammation biomarker was standardized using z scores to calculate inflammation standardized sumscores. Plaque vulnerability of culprit lesions was measured in vivo using optical coherence tomography. Results: The presence of type D personality (38%) was associated with TNF-α, IL-6, and inflammation standardized sumscores ( t = 2.74, Cohen d = 0.32, p = .006; t = 4.03, Cohen d = 0.44, p ≤. 001; t = 4.16, Cohen d = 0.11, p = .001, respectively). In addition, the standardized inflammation sumscore was a mediator of the relationship between type D personality and lipid-rich plaques (effect sizes = 0.12, 95% confidence interval = 0.007–0.286, p = .064) and plaque rupture vulnerability (effect sizes = 0.16, 95% confidence interval = 0.043–0.365, p = .024). Analysis of continuous type D scores revealed that TNF-α, IL-6, and inflammation standardized sumscores also mediate the relationship between the primary effect of negative affectivity and plaque vulnerability. Conclusions: Inflammation activation is a potential mediator of the association between type D personality and plaque vulnerability. The negative affectivity component of type D personality might be particularly relevant to the inflammatory aspects of plaque vulnerability.