Association of type-D personality and left-ventricular remodelling in patients treated with primary percutaneous intervention after ST-segment elevation myocardial infarction

Background Type-D personality is an established predisposing factor for various diseases.Type-D traits have been shown to pose a 26% increased risk of coronary artery disease after controlling for other confounding factors. Significant associations have been reported between type-D personality traits and dyslipidaemia, impaired endothelial function, coronary heart disease (CAD), acute myocardial infarction, and other adverse cardiovascular events. Objective To assess the association between type-D personality and left-ventricular adverse remodelling in patients treated with percutaneous coronary intervention following index ST-segment elevation myocardial infarction. Methods All patients hospitalized and treated with percutaneous coronary intervention (PCI) after their index ST-segment elevation myocardial infarction (STEMI) between 1 January 2022 to 31 December 2023 were prospectively enrolled.Type-D personalitytraits in the study population were determined at baseline using type-D Scale-14 (DS14) instrument, whereas any positive change in left ventricular end diastolic volume (LVEDV) >= 20% at follow up period of 12-months from baseline was defined as left-ventricular adverse remodelling (LVAR). Univariate and multivariate analysis was done to establish the independent predictors of LVAR.The area under receiver-operating characteristic curve (AUROC) was employed to assess the sensitivity and specificity of the identified independent predictors. Results A total of 124 patients were enrolled in the study. The mean age of the study population was 67 +/- 10 years and the overall incidence of LVAR was found to be 25%. Multivariate regression analysis revealed that type-D personality is a significant independent predictor of LVAR (OR : 2.51; 95%CI : 1.16 - 5.77; p = 0.03) apart from the already established independent predictors Killip Class(OR : 7.30; 95%CI : 3.03- 17.55; p < 0.0001) , baseline Global Longitudinal strain (GLS) (OR : 2.69; 95%CI : 1.19- 6.61;p = 0.01), and 3-vessel CAD (OR : 2.27; 95CI: 1.10 - 5.33; p = 0.04). In ROC curve analysis type-D personality as an independent predictor of LVAR achieved a sensitivity of 41.4% and a specificity of 87.1%, p < 0.02. Conclusion Type-D personality trait is a significant independent predictor of LVAR in patients treated with PCI after their index-STEMI.