Abstract

Background: The aim of this study was to comprehensively analyze the relationships within a multimodal biomarker panel, including endothelial function indicators, markers of systemic inflammation and myocardial stress, metabolic homeostasis parameters, and an indicator of microstructural damage to nerve tissue in CAD patients with or without type D personality. Methods: This exploratory, cross-sectional, observational study included 72 patients with coronary artery disease. All patients underwent psychological testing (evaluation of type D personality and determination of depression and anxiety levels) and biomarker measurements. The multimodal biomarker panel included measurements of metabolic homeostasis parameters (glucose, total cholesterol, creatinine, insulin, 1,5-anhydroglucitol), markers of systemic inflammation (CRP, IL-6), myocardial stress (NTproBNP), endothelial function parameters (eNOS, EDN1, ADMA, VEGF), and an indicator of microstructural damage to nerve tissue (S100B protein). Results: Biomarker levels revealed no statistically significant differences between the groups with and without personality type D. In personality type D, a direct correlation was found between the level of the brain tissue damage marker S100B and eNOS concentration (R = 0.578; p = 0.006), which was not observed in non-type D. In patients with personality type D, a significant inverse correlation was confirmed between ADMA and creatinine levels (R = −0.524; p = 0.015). In individuals with non-type D personality, a direct correlation was established between total cholesterol levels and VEGF (R = 0.342; p = 0.014). Conclusions: In patients with coronary heart disease, psychological distress (type D) is associated not with an isolated change in biomarker concentrations but with a transformation of the entire structure of their relationships. Personality type D is characterized by a transition from the physiological autonomy of systems to the formation of pathogenetic relationships between them, indicating a decrease in adaptive reserve.

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