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Coronary disease & ACSCohort study

Type D personality, unhealthy behaviours, and 2-year outcomes after acute coronary syndrome: a cohort study

Eur J Prev CardiolPublished

  • Cohort study
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Authors' conclusion

Individuals with Type D personality and intermediate or poor CVH exhibited an elevated risk of MACE. Individuals without Type D personality but with poor CVH also exhibited an elevated risk.

Study context

Population
Patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), May 2017–September 2023; Type D = Type D Scale-14 scores ≥ 10 on both subscales; Cardiovascular health (CVH) by Life's Essential 8 (poor 0–49, intermediate 50–79, ideal 80–100)2,117 developed major adverse cardiovascular events (MACE)
Participants
10,003 patients
Exposure
Type D personality and CVH category vs Type D ideal CVH
Outcome
MACE:
  • Stroke
  • Non-fatal MI
  • Revascularization
  • Cardiac death
  • Cardiac hospitalization
Follow-up
2 years

Main finding

As reported in the abstract

2-year MACE
Each group vs type D (-) ideal CVHHazard ratio (95% CI)P value
Type D (+) poor CVH
2.960(2.238–3.914)
P < 0.001
Type D (+) intermediate CVH
2.270(1.739–2.962)
P < 0.001
Type D (-) poor CVH
1.953(1.501–2.541)
P < 0.001

Observational data: associations, not effects.

Further findings

OutcomeHR (95% CI)P value
MACE, reference Type D (+) ideal CVH — Type D (+) intermediate CVH vs Type D (+) ideal CVH1.895 (1.274–2.820)P = 0.002
MACE, reference Type D (+) ideal CVH — Type D (+) poor CVH vs Type D (+) ideal CVH2.471 (1.645–3.713)P < 0.001
MACE, reference Type D (+) ideal CVH — Type D (-) poor CVH vs Type D (+) ideal CVH1.631 (1.092–2.436)P = 0.017

MACE by health behaviour vs health factor dimensions (Type D personality)

Health behaviours, intermediate
HR 1.864, 95% CI: 1.348-2.578, p < 0.001
Health behaviours, poor
HR 2.452, 95% CI: 1.776-3.387, p < 0.001
Health factors, intermediate
HR 1.640, 95% CI: 1.280-2.101, p < 0.001
Health factors, poor
HR 2.131, 95% CI: 1.629-2.787, p < 0.001

Physical activity, blood glucose and sleep

Type D: intermediate or poor levels associated with higher MACE risk; non-Type D: only poor levels
all p < 0.05

Original publication

Type D personality, unhealthy behaviours, and 2-year outcomes after acute coronary syndrome: a cohort study. Eur J Prev Cardiol. Published 13 November 2025. doi:10.1093/eurjpc/zwaf727
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Summarised from the published abstract; every number is checked against it