Association between affective temperaments and the severity and the extent of coronary artery disease as obtained by coronary CT angiography

Barbara Sipos, Milán Vecsey-Nagy, Borbála Vattay, Melinda Boussoussou, Zsófia Jokkel, Sarolta Borzsák, Ádám Jermendy, Alexis Panajotu, Xenia Gonda, Zoltán Rihmer, Béla Merkely, Bálint Szilveszter, János Nemcsik

Keywords: Affective temperaments, Coronary artery disease, Coronary CT angiography

Background:

Affective temperaments are documented predictors of psychopathology, but cumulating data suggest their relationship with coronary artery disease (CAD).

Research questions:

We aimed to evaluate role of affective temperaments in relation to surrogate semiquantitative markers of coronary plaque burden, as assessed by coronary CT angiography (CCTA). We also wanted to compare the application of 110-item to the 40-item TEMPS-A autoquestionnaire.

Method:

We included 351 patients who were referred for CCTA due to suspected CAD. All patients completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A). The severity and extent of CAD was evaluated by CCTA, applying semiquantitative plaque burden scores, notably Segment Involvement Score (SIS) and Segment Stenosis Score (SSS). Logistic regression analyses were performed to define the predictors of CAD severity and extent.

Results:

Regarding the scores evaluated by TEMPS-A that consists of 110 questions, in men, significant inverse association was found between hyperthymic temperament score and SSS (β=-0.143, (95%CI:-0.091 to -0.004), p=0.034). Compared to the TEMPS-A form, applying the abbreviated version – containing 40 questions – significant relationship between affective temperaments and SSS or SIS was found in case of both sexes. Concerning men, hyperthymic temperament was demonstrated to be independent predictor of both SSS (β=-0.193, (95%CI:-0.224 to -0.048), p=0.004) and SIS (β=-0.194, (95%CI:-0.202 to -0.038), p=0.004). Additionally, we proved, that significant positive association between irritable temperament and SSS (β=0.152, (95%CI:0.002 to 0.269), p=0.047) and SIS (β=0.155, (95%CI:0.004 to 0.221), p=0.042) exists among women.

Conclusions:

Assessment of affective temperaments could offer added value in stratifying cardiovascular risk for patients beyond traditional risk factors in general practice.

Points for discussion:

Female and male population were assessed separately.

Differences were found between applying the 110-item autoquestionnaire and the 40-item abbreviated version regarding female population.

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