Mechanism of type D personality on plaque vulnerability in patients with coronary heart disease
10.3760/cma.j.cn115682-20220109-00116
- VernacularTitle:D型人格与冠心病患者发生斑块易损性的相关分析
- Author:
Xinrui MA
1
;
Xueqin GAO
;
Ping LIN
;
Zhenjuan ZHAO
;
Yini WANG
Author Information
1. 哈尔滨医科大学附属第二医院心内科，哈尔滨 150086
- Keywords:
Coronary atherosclerotic heart disease;
Type D personality;
Plaque vulnerability;
Optical coherence tomography;
Structural equation model
- From:
Chinese Journal of Modern Nursing
2022;28(16):2137-2143
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To clarify the mechanism of type D personality on plaque vulnerability in patients with coronary heart disease based on the stress-mediator model.Methods:Using the convenient sampling method, a total of 386 patients with coronary heart disease who were admitted to Department of Cardiology of the Second Affiliated Hospital of Harbin Medical University from December 2020 to May 2021 were selected as the research objects. The patients were investigated using Type D Personality Scale-14 (DS-14) , Self-rating Anxiety Scale, Self-rating Depression Scale, The Stress Appraisal Measure (SAM) and Trait Coping Style Questionnaire (TCSQ) . At the same time, optical coherence tomography was used to evaluate the plaque characteristics of patients with coronary lesions. A structural equation model was used to construct a model of influencing factors of plaque vulnerability in patients with type D personality coronary heart disease.Results:Among the patients with coronary heart disease in this study, there were 138 patients with type D personality and 200 patients in the vulnerable plaque group. The D-type personality score, anxiety, depression, negative coping and cognitive evaluation scores in the vulnerable plaque group were higher than those in the non-vulnerable plaque group, and the differences were statistically significant ( P<0.01) . The active coping score of the vulnerable plaque group was lower than that of the non-vulnerable plaque group, and the difference was statistically significant ( P<0.01) . The results of structural equation modeling showed that type D personality could directly or indirectly affect plaque vulnerability through cognitive assessment (β=0.588, P<0.01) and negative coping (β=0.189, P<0.05) . Among them, cognitive assessment (β=-0.061, 0.121; P<0.01) and negative coping (β=-0.124, 0.031; P<0.01) had indirect effects on plaque vulnerability. Negative coping (β=0.215, P<0.01) , psychological responses (β=0.241, -0.150, P<0.01) and physiological responses (β=-0.321, P<0.01) had direct effects on plaque vulnerability. Conclusions:Cognitive evaluation, coping style, psychological response and physiological response of patients with type D coronary heart disease can affect plaque vulnerability through various pathways. Therefore, strengthening the clinical screening of type D personality can early identify the high-risk population of plaque vulnerability, and at the same time, individualized and systematic psychological behavior intervention should be carried out for such population, so as to move the prevention and treatment of coronary heart disease forward.
