Association of Type D Personality and Anatomical Complexity as Predictors of Long-Term Mortality in Coronary Artery Disease: A Retrospective Case Study Based on Hospital Records

作者：Nakhebi OASA, Susan R, Mihai A, Bumbu GA, Mindru FM, Mornoș C, Enătescu VR · 发表于：Diseases (Basel, Switzerland) · 年份：2026 · DOI：10.3390/diseases14070244 · 被引用次数：54

Background: Traditional cardiovascular risk models often overlook "residual risk" driven by psychopathological factors. This study investigates the exploratory prognostic baseline associations of Type D personality (TDP) and specific symptomatic dimensions with long-term all-cause mortality in patients with coronary artery disease (CAD). Methods: We conducted a retrospective case study based on hospital records evaluating 221 patients with confirmed CAD. Anatomical complexity was quantified via the SYNTAX Score (SS). Psychological profiling utilized the DS14 scale for TDP and the SCL-90 for granular symptoms (depression, anxiety, and hostility). Mortality was analyzed over a mean follow-up of 1026 days using multivariate Cox proportional hazards models. Results: Over a mean follow-up of 1026 days, the overall all-cause mortality rate was 33.0% (n=73). TDP prevalence was 19.0% (n=42) and significantly correlated with higher anatomical complexity (SS: 26.21 vs. 15.49; p<0.001). In the adjusted psychological model, baseline anxiety symptom severity presented an exploratory, borderline relationship with survival (HR = 0.941; p=0.049), with the 95% confidence interval upper bound reaching the null threshold (1.000), suggesting a potential, hypothesis-generating "Anxiety Paradox". The psychological model demonstrated variations in descriptive validation indices (C-index = 0.624) compared to a baseline model integrating trait metrics and anatomical severity (C-index = 0.527). Signif...