The Personality And Psychological Stress Of Patients With Coronary Heart Disease After Coronary Intervention

BackgroundCoronary atherosclerotic heart disease is a typical psychosomatic disease which is inflicting human health around the word. Recently, as more and more young people are having CHD it has one of the main diseases with high rate of morbidity and mortality. The pathogenesis of CHD is very complex which is always the focus of researchers.Most studies show that psychological and social factors play an import role in the etiology of CHD. Among them are personality and psychosocial stresses. Furthermore, other factors, such as cognitive model, social support and coping style, also affect the development of coronary heart disease. Anxiety and depression are common emotions in coronary heart disease. In addition, the onset and development of CHD is a heavy burden for the patient. Among all factors that affect CHD are psychological factors, especially personality. Lots of evidence has shown that type A personality is an independent factor that affects the development of CHD. Many studies have shown that type D personality is closely related to onset of CHD and can cause CHD independently. Furthermore, type D personality is a key factor that influences the development of CHD. In China, there are a few clinical studies focusing on type D personality. Coronary stent implantation is one of the most popular interventions for the patients with coronary heart disease. However, it also is a stressor and must cause some psychological or physiological changes. The aim of the present study is to examine the relationship of CHD and type D personality as well as other psychological factors.AimThe first aim of the study is to assess the type of personality in patients with CHD. The second is to explore psychological reaction of the patients following coronary stent implantation. The third is to survey the difference among personality, emotion, mental health and coping style.Method90patients (45cases of stable angina and45unstable angina and30normal people) were included in the study. All these subjects were tested by type A behavior questionnaire, D personality questionnaire, SAS, SDS, trait coping scale and SCL-90at3days after coronary intervention. Meanwhile, the levels of plasma CTNI、CKMB、 LDH、LDH1were tested.Results1. There were significant different in ratio of type A behavior in3groups (χ2=21.168, P<0.0\), there were not obvious different in ratio of type D behavior in3groups. But ratio of A personality and D personality in unstable angina was higher than that of control group and stable angina group. The scores of A personality and D personality of unstable angina group were higher than that of control group and stable angina group (P<0.05; P<0.01).2. The scores of SAS, SDS and SCL-90of patient group were significantly higher than that of normal group (P<0.05; P<0.01), while the above measures in unstable group were higher than those of stable study (P<0.01; P<0.05)3. Patients group had lower skin resistance than normal people, especially; the unstable group had profound lower skin resistance than the other two groups.4. Compared with control group and stable angina group, Unstable angina group had significant higher levels of CTNI, CKMB, LDH and LDH1(P<0.05; P<0.00).5. The unstable group had lower sores in positive coping style than stable group and had higher scores in negative coping style.6. The plasma CTNI、CKMB、LDH、LDH1had positive related with anxiety, depression and low level of mental health and LDH had negative related with type A behavior. The anxiety, depression and low level of mental health had negative relation with A personality, D personality and positive coping, had positive related with negative coping.Conclusions:1. Patients with CHD had A and D personality tendencies and A and D personality tendencies of patients were related with myocardial injury.2. After the implantation of coronary stent, the patient with coronary heart disease had higher responses of stress including anxiety, depression, and lower mental health. Personality had an influential effect on the development of the patients following the intervention; psychological stress of patients with CHD was closely related with personality and coping style.