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The Relationship Between Type D Personality with Atherosclerotic Plaque and Cardiovascular Events: The Mediation Effect of Inflammation and Kynurenine/tryptophan Metabolism

Overview

Overview

Journal Front Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2022 Nov 3

PMID 36324755

Authors

Authors

Yini Wang

Guojie Liu

Zhenjuan Zhao

Ling Li

Shi Yin

Xiao Sun

Bo Yu

Xueqin Gao

Ping Lin

Yanjie Yang

Affiliations

Affiliations

Soon will be listed here.

Abstract

Purpose: Cardiovascular events and coronary plaque vulnerability are linked to Type D personality. However, the fundamental mechanism has not been clarified. Our study determined to illustrate whether inflammatory status in plasma, in combination with kynurenine pathway activity in Type D individuals, is associated with plaque vulnerability and cardiovascular events in patients with coronary artery disease (CAD).

Materials And Methods: The Type D personality of 177 CAD patients were evaluated. Plasma biomarkers of inflammation (TNF-α, IL-6, and hs-CRP) were measured and pooled into standardized sumscores. Tryptophan and kynurenine metabolites were measured, and the kynurenine/tryptophan ratio (KTR) was calculated. Plaque vulnerability was measured by optical coherence tomography. All patients had a follow up of 2 years in which cardiovascular adverse events were recorded.

Results: Type D individuals exhibited elevated TNF-α ( = 0.007), IL-6 ( = 0.049), inflammation sumscores ( = 0.002), kynurenine ( = 0.008), and KTR ( = 0.005) than non-Type D group. The serial-multiple mediation showed that the Type D personality with a direct, favorable impact on plaque vulnerability, including thin cap fibroatheroma (TCFA) (point estimate = 0.81; 95% = 0.09-1.53), macrophages (point estimate = 0.79; 95% = 0.05-1.51), and major adverse cardiac events (MACE) (point estimate = 0.88, 95% = 0.08-1.70). In addition, the standardized inflammation sumscores and KTR were mediators of the Type D personality associations with TCFA, macrophages and MACE.

Conclusion: These results demonstrated that the connection between Type D personality and poor cardiovascular outcomes in CAD patients can be mediated by pro-inflammatory biomarkers and KTR.

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