Occurrence of myocardial ischemia in patients undergoing pharmacologic stress echocardiography: the impact of type-D personality

Rafael Borsoi, Viviane Vidal Sabatoski, Ana Paula Higa Ogawa, Aline Fontana, Liz Andrea Villela Baroncini, Admar Moraes de Souza, Cláudio Pereira da Cunha


Background: Type‑D personality has been identified as a risk factor for general and cardiac mortality in patients with coronary artery disease (CAD). Dobutamine‑atropine stress echocardiography (DASE) is an established method for non‑invasive evaluation of myocardial ischemia in patients with CAD. The objective of this study was to evaluate the prevalence of type‑D personality and its association with the occurrence of myocardial ischemia as assessed by DASE.

Methods: This case‑control study enrolled 306 patients (61 ± 9.6 years, 57.8% female) who were referred by physicians to assessment of myocardial ischemia. Before undergoing DASE, the patients answered the type‑D scale, which identifies type‑D personality.

Results: Type‑D personality was identified in 106 patients (34.6%). DASE was positive for myocardial ischemia in 32.4% (99) of 306 participants there was no significant association between type‑D personality and ischemic changes on DASE (P = 0.941; odds ratio: 0.98; confidence interval 95%: 0.57‑1.69). Chest pain was the only clinical variable with statistically significant prevalence in type‑D personality patients (77.4% vs. 57.0%; P < 0.001).

Conclusions: Type‑D personality was not a significant risk factor for the presence of ischemic changes on DASE. Patients with type‑D personality tended to complain more frequently of chest pain than non‑type‑D patients.

Keywords: Coronary artery disease, myocardial ischemia, psychological risk factor, stress echocardiography, type‑D personality

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