Jieyun Yin1, Chongke Zhong2, Zhengbao Zhu1, Xiaoqing Bu2, Tan Xu1, Libing Guo3, Xuemei Wang4, Jintao Zhang5, Yong Cui6, Dong Li7, Jianhui Zhang8, Zhong Ju9, Chung-Shiuan Chen10, Jing Chen11, Yonghong Zhang12, Jiang He13. 1. Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. 2. Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA. 3. Department of Neurology, Siping Central Hospital, Jilin, China. 4. Department of Neurology, Jilin Central Hospital, Jilin, China. 5. Department of Neurology, the 88th Hospital of PLA, Shandong, China. 6. Department of Neurology, General Hospital of First Automobile Works, Jilin, China. 7. Department of Internal Medicine, Feicheng City People's Hospital, Shandong, China. 8. Department of Neurology, Tongliao Municipal Hospital, Inner Mongolia, China. 9. Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Inner Mongolia, China. 10. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA. 11. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA. 12. Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. Electronic address: yhzhang@suda.edu.cn. 13. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA. Electronic address: jhe@tulane.edu.
Abstract
BACKGROUND:Homocysteine (HCY) and high sensitivity C reactive protein (hs-CRP) were suggested to be involved in post-stroke depression (PSD), which is a frequent mood disorder after stroke. However, the combined effect of HCY and hs-CRP on PSD remains unclear. METHODS: A total of 598 acute ischemic stroke patients from 7 of 26 centers participating in the China Antihypertensive Trial in Acute Ischemic Stroke with HCY or hs-CRP measurements were included in this analysis. PSD status was evaluated by 24-item Hamilton Depression Rating Scale at 3 months after stroke. RESULTS:Two hundred and forty-one (40.30%) participants were considered as PSD. HCY and hs-CRP levels were not significantly different between PSD and non-PSD patients. Interesting, in a maximally adjusted model, the odds ratio (95% confidence interval) of PSD was 1.90 (1.18-3.06) for coexistence of HCY ≥ 14.65 μmol/l and hs-CRP ≥ 1.90 mg/l compared with the other levels (HCY < 14.65 μmol/l and/or hs-CRP < 1.90 mg/l). Adding combination of HCY and hs-CRP to a model containing conventional risk factors could significantly improve risk reclassification for PSD. CONCLUSIONS: Coexistence of both higher HCY and higher hs-CRP in the acute phase of ischemic stroke were associated with subsequent PSD, independently of established conventional risk factors.
RCT Entities:
BACKGROUND:Homocysteine (HCY) and high sensitivity C reactive protein (hs-CRP) were suggested to be involved in post-stroke depression (PSD), which is a frequent mood disorder after stroke. However, the combined effect of HCY and hs-CRP on PSD remains unclear. METHODS: A total of 598 acute ischemic strokepatients from 7 of 26 centers participating in the China Antihypertensive Trial in Acute Ischemic Stroke with HCY or hs-CRP measurements were included in this analysis. PSD status was evaluated by 24-item Hamilton Depression Rating Scale at 3 months after stroke. RESULTS: Two hundred and forty-one (40.30%) participants were considered as PSD. HCY and hs-CRP levels were not significantly different between PSD and non-PSDpatients. Interesting, in a maximally adjusted model, the odds ratio (95% confidence interval) of PSD was 1.90 (1.18-3.06) for coexistence of HCY ≥ 14.65 μmol/l and hs-CRP ≥ 1.90 mg/l compared with the other levels (HCY < 14.65 μmol/l and/or hs-CRP < 1.90 mg/l). Adding combination of HCY and hs-CRP to a model containing conventional risk factors could significantly improve risk reclassification for PSD. CONCLUSIONS: Coexistence of both higher HCY and higher hs-CRP in the acute phase of ischemic stroke were associated with subsequent PSD, independently of established conventional risk factors.
Authors: Maria Paola Lauretta; Rita Maria Melotti; Corinne Sangermano; Anneliya Maria George; Rafael Badenes; Federico Bilotta Journal: J Clin Med Date: 2022-01-13 Impact factor: 4.241