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. 2020 Sep;12(9):4680-4689.
doi: 10.21037/jtd-20-1546.

The impact of the Type D Personality pattern on prehospital delay in patients suffering from acute myocardial infarction

Youyang Zhang  1 , Shihao Wu  2 , Jiangqi Pan  3 , Sophia Hoschar  4   5 , Zhen Wang  6 , Rongxiang Tu  1 , Karl-Heinz Ladwig  7 , Wenlin Ma  1   2
Affiliations

The impact of the Type D Personality pattern on prehospital delay in patients suffering from acute myocardial infarction

Youyang Zhang et al. J Thorac Dis. 2020 Sep.

Abstract

Background: The Type D Personality (TDP) has been specifically linked to acute myocardial infarction (AMI). However, the impact on prehospital delay of AMI patients is unclear. The aim of this study was to assess the relationship between TDP and pre-hospital delay time (PHT) in a Chinese population.

Methods: A total of 256 AMI patients (47 women and 209 men) were taken from the Multicenter Delay in Patients Experiencing AMI in Shanghai (MEDEA FAR-EAST) study. Sociodemographic and psycho-behavioral characteristics were assessed by bedside interviews and questionnaires. TDP was evaluated according to the Type D Personality Scale (DS14) subdivided in social inhibition (SI) and negative affectivity (NA). Based on a significant interaction analysis of TDP and sex on PHT, all analyses were stratified by sex.

Results: PHT of female patients with TDP were substantially shorter compared to non-TDP female patients (108 vs. 281 min, P=0.029). In male patients, no effect of TDT on PHT was found. Spearman correlation analysis suggests that NA was negatively correlated with PHT (r=-0.358, P=0.014). Further age-adjusted logistic regression analyses showed that female patients with TDP were generally less likely to prehospital delay compared with non-TDP patients (OR =0.28; 95% CI, 0.08-0.98) and had a lower risk of PHT >360 minutes (OR =0.10; 95% CI, 0.01-0.91). However, statistical significance disappeared after adjustment for psychological factors (anxiety, depression, suboptimal wellbeing, cardiac denial and stress event).

Conclusions: TDP is associated with less prehospital delay in female patients during AMI-an effect which may be particularly mediated by NA.

Keywords: Type D Personality (TDP); acute myocardial infarction (AMI); decision time; prehospital delay.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd-20-1546). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Non-parametric Wilcoxon test for comparing PHT and DT (in min) for all patients with and without TDP and stratified for women and men. The punctuation ‘*’ represented P<0.05. (A) The difference of PHT in men: non-TDP: 145.5 (391.3) vs. TDP: 150.0 (455.0), P=0.832. For women: non-TDP: 281.0 (978.0) vs. TDP: 108.0 (173.8), P=0.029. For the total population: non-TDP: 156.0 (469.0) vs. TDP: 120.0 (379.0), P=0.492. (B) The difference of DT for men: non-TDP:90.0 (343.5); TDP: 120.0 (390.0), P=0.931. For women: non-TDP: 240.0 (970.0) vs. TDP: 37.5 (127.5), P=0.032. For the total population: non-TDP: 95.0 (410.0); TDP: 75.0 (340.0), P=0.433. Data were shown as median (IQR). PHT, pre-hospital delay time; TDP, Type D Personality.
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