Poststroke depression and risk of recurrent stroke

Abstract

Background:Conflicting results have been reported on the association of poststroke depression with recurrent stroke events. This meta-analysis of prospective studies aims to evaluate whether poststroke depression is an independent predictor of stroke recurrence among stroke patients.Methods:A systematic search of articles in PubMed and Embase databases from their inception to October 2018 was conducted. Prospective studies reporting risk estimates of stroke recurrence by depression status in stroke patients were included and pooled risk ratio (RR) with 95% confidence intervals (CIs) of stroke recurrence was calculated for patients with or without poststroke depression.Results:Six studies with 4648 stroke patients were finally included, and the prevalence of poststroke depression was found to from 15.9% to 40.5%. The pooled adjusted RR for stroke recurrence in patients suffering from poststroke depression was 1.48 (1.22–1.79) in a fixed-effect model. Subgroup analyses indicated that poststroke depression significantly increased stroke recurrence (RR 1.64; 95% CI, 1.28–2.10) among ischemic stroke patients but not in total stroke patients (RR 1.28; 95% CI, 0.96–1.73).Conclusions:This meta-analysis suggests that poststroke depression may be an independent predictor of stroke recurrence among ischemic stroke patients. Further studies are required to investigate whether treatment of poststroke depression can reduce the risk of stroke recurrence.

Post Stroke Depression to be Expected

“…A prospective study including patients with concomitant stroke and depression revealed that PSD doubled the risk for stroke recurrence at the end of one year and resulted in a shorter time period for its occurrence [14]. A similar conclusion was drawn in a meta-analysis of six studies performed by Wu et al and further adds that ischemic stroke in particular augmented the risk for re-stroke [15]. On the other hand, the association of PSD is also related to increased risk of death from all causes.…”

“…In addition to its negative impact on the quality of life and functional recovery, PSD is also associated with an increased risk of stroke recurrence and mortality [14,15]. A prospective study including patients with concomitant stroke and depression revealed that PSD doubled the risk for stroke recurrence at the end of one year and resulted in a shorter time period for its occurrence [14].…”

“…The Secondary Prevention of Small Subcortical Strokes (SPS3) trial revealed that 19% of stroke patients suffered from post-stroke depression (PSD) while a meta-analysis of 51 observational studies estimates that one out of every three stroke survivors suffer from the PSD [6,7]. Patients with PSD have been shown to have poorer neurological outcomes and its economic costs are staggering affecting health systems at a global scale ( [8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Understanding Why Post-Stroke Depression May Be the Norm Rather Than the Exception: The Anatomical and Neuroinflammatory Correlates of Post-Stroke Depression

“…The Secondary Prevention of Small Subcortical Strokes (SPS3) trial revealed that 19% of stroke patients suffered from post-stroke depression (PSD), while a meta-analysis of 51 observational studies estimates that one out of every three stroke survivors suffer from the PSD [ 9 , 10 ]. Patients with PSD have been shown to have poorer neurological outcomes, and its economic costs are staggering, affecting health systems at a global scale [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ].…”

Predictive value of Alberta stroke program early CT score for perfusion weighted imaging - diffusion weighted imaging mismatch in stroke with middle cerebral artery occlusion

“…[ 1 , 2 ] It has a high disability and mortality, which is affected by many risk factors. [ 3 – 5 ] In the first few hours after AIS, the severity and irreversibility of brain injury increase as time passes. There is often a larger component of brain tissue that is hypoperfused but viable surrounding the irreversible infarction of brain tissue (core infarction), that is penumbra.…”