The impact of Type D personality and high-sensitivity C-reactive protein on health-related quality of life in patients with atrial fibrillation

Abstract

Background: Anxiety or depressive symptoms are known to be predictors of impaired health-related quality of life (HRQoL). However, little research has focused on the impact of Type D personality as chronic psychological distress on HRQoL in atrial fibrillation (AF) patients. Increased high-sensitivity C-reactive protein (hsCRP) is likely to be associated with anxiety or depressive symptoms, whereas the relation of hsCRP to Type D personality was unexplored, and the impact of hsCRP on HRQoL was undetermined in AF patients. Aim: To determine whether Type D personality and hsCRP are independently associated with impaired HRQoL. Methods: A cross-sectional study design was used among a total of 114 patients with chronic AF. Patients underwent measurements of serum levels of hsCRP. Type D personality, anxiety and depressive symptoms, and HRQoL were assessed by the Type D Scale, the Hospital Anxiety and Depression Scale, and the Short-Form Medical Outcomes Survey, respectively. Hierarchical linear regression was used to determine the impact of Type D personality and hsCRP on HRQoL. Results: Thirty-two percent of patients had Type D personality. Patients with Type D personality had higher hsCRP than those with non-Type D personality (1.4 +/- 1.9 vs. 0.6 +/- 2.2, p = 0.046). In hierarchical linear regression, Type D personality (beta = -0.28; p = 0.005) and hsCRP (beta = -0.21; p = 0.034) were independently associated with HRQoL controlling for clinical risk factors, anxiety, and depression symptoms. Conclusions: Type D personality and hsCRP are independent predictors of impaired HRQoL. Clinicians need to pay attention to patients with Type D personality and monitor serum levels of hsCRP to prevent impaired HRQoL in AF patient.