The negative affectivity dimension of Type D personality is associated with in-stent neoatherosclerosis in coronary patients with percutaneous coronary intervention: An optical coherence tomography study

In-stent neoatherosclerosis (ISNA) is involved in the pathogenesis of in-stent restenosis and major adverse cardiac events (MACE) in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI). We aimed to explore the association between Type D personality and ISNA via in vivo optical coherence tomography (OCT). One hundred and fifty-six patients with CAD completed the Type D Scale-14 and underwent in vivo measurement of in-stent neoatherosclerosis by OCT. The Type D construct was analyzed as both the dichotomous and the dimension constructs. After adjusting for demographic and clinical factors and presenting as a dichotomous construct, Type D personality was independently associated with the presence of in-stent neoatherosclerosis (odds ratio [OR] = 2.99, 95% confidence interval [CI] = 1.35–6.63, p = 0.007) and in-stent thin-cap fibroatheroma (OR = 2.81, 95% CI = 1.27–6.23, p = 0.01). Meanwhile, the multiple logistic regression also showed that the main effect of negative affectivity was an independent risk factor of in-stent neoatherosclerosis (OR = 1.85, 95% CI = 1.25–2.75, p = 0.002) and in-stent thin-cap fibroatheroma (OR = 1.77, 95% CI = 1.18–2.67, p = 0.006). However, the main effects of social inhibition with in-stent neoatherosclerosis and in-stent thin-cap fibroatheroma (OR = 0.98, 95% CI = 0.64–1.52, p = 0.94; OR = 0.94, 95% CI = 0.63–1.39, p = 0.75, respectively) as well as the interaction of negative affectivity and social inhibition were not significant (OR = 0.71, 95% CI = 0.69–1.81, p = 0.11; OR = 0.72, 95% CI = 0.47–1.08, p = 0.12, respectively). Type D personality was found to be independently associated with in-stent neoatherosclerosis via OCT in patients with CAD after PCI. It was negative affectivity, not social inhibition, that affected the occurrence of the in-stent neoatherosclerosis, these results challenged the usefulness of the Type D construct. Our findings may provide new insights regarding the mechanisms of the association between Type D personality and MACE after PCI. •Our results indicated that Type D personality was associated with ISNA.•NA, not SI, explained the association between Type D personality and ISNA.•Our results provide new insights into the mechanism of NA dimension and MACEs after PCI.