Repositorio UFRO · Omeka S

Depressive Symptoms and Risk of Acute Stroke INTERSTROKE Case-Control Study

Primer Autor	Murphy, Robert
Co-autores	Reddin, Catriona Rosengren, Annika Judge, Conor J. Hankey, Graeme Ferguson, John Alvarez-Iglesias, Alberto Oveisgharan, Shahram Wasay, Mohammad McDermott, Clodagh Iversen, Helle Klingenberg Lanas, Fernando Al-Hussain, Fawaz Czlonkowska, Anna Oguz, Aytekin Ogunniyi, Adesola Damasceno, Albertino Xavier, Denis Avezum, Alvaro Wang, Xingyu Langhorne, Peter Yusuf, Salim O'Donnell, Martin
Título	Depressive Symptoms and Risk of Acute Stroke INTERSTROKE Case-Control Study
Editorial	LIPPINCOTT WILLIAMS & WILKINS
Revista	NEUROLOGY
Lenguaje	en
Resumen	Background and Objectives Depression has been reported to be a risk factor of acute stroke, based largely on studies in high income countries. In the INTERSTROKE study, we explored the contribution of depressive symptoms to acute stroke risk and 1-month outcome across regions of the world, within subpopulations and by stroke type. Methods The INTERSTROKE is an international case-control study of risk factors of first acute stroke, conducted in 32 countries. Cases were patients with CT- or MRI-confirmed incident acute hospitalized stroke, and controls were matched for age, sex, and within sites. Standardized questions asked about self-reported depressive symptoms during the previous 12 months and the use of prescribed antidepressant medications were recorded. Multivariable conditional logistic regression was used to determine the association of prestroke depressive symptoms with acute stroke risk. Adjusted ordinal logistic regression was used to explore the association of prestroke depressive symptoms with poststroke functional outcome, measured with the modified Rankin scale at 1 month after stroke. Results Of 26,877 participants, 40.4% were women, and the mean age was 61.7 +/- 13.4 years. The prevalence of depressive symptoms within the last 12 months was higher in cases compared with that in controls (18.3% vs 14.1%, p < 0.001) and differed by region (p interaction <0.001), with lowest prevalence in China (6.9% in controls) and highest in South America (32.2% of controls). In multivariable analyses, prestroke depressive symptoms were associated with greater odds of acute stroke (odds ratio [OR] 1.46, 95% CI 1.34-1.58), which was significant for both intracerebral hemorrhage (OR 1.56, 95% CI 1.28-1.91) and ischemic stroke (OR 1.44, 95% CI 1.31-1.58). A larger magnitude of association with stroke was seen in patients with a greater burden of depressive symptoms. While preadmission depressive symptoms were not associated with a greater odds of worse baseline stroke severity (OR 1.02, 95% CI 0.94-1.10), they were associated with a greater odds of poor functional outcome at 1 month after acute stroke (OR 1.09, 95% CI 1.01-1.19). Discussion In this global study, we recorded that depressive symptoms are an important risk factor of acute stroke, including both ischemic and hemorrhagic stroke. Preadmission depressive symptoms were associated with poorer functional outcome, but not baseline stroke severity, suggesting an adverse role of depressive symptoms in poststroke recovery.
Fecha Publicación	2023
Tipo de Recurso	artículo original
doi	10.1212/WNL.0000000000207093
Formato Recurso	PDF
Palabras Claves	Aged Case-Control Studies Cerebral Hemorrhage / epidemiology Depression Female Humans Male Middle Aged Risk Factors Stroke / epidemiology
Ubicación del archivo	http://dx.doi.org/10.1212/WNL.0000000000207093
Categoría OCDE	Neurociencias y Neurología
Materias	Envejecimiento Estudios de casos y controles Hemorragia Cerebral / epidemiología Depresión Femenino Humanos Masculino mediana edad Factores de riesgo Accidente cerebrovascular / epidemiología
Página final (Recomendado-único)	E1798
Identificador del recurso (Mandatado-único)	artículo original
Versión del recurso (Recomendado-único)	versión publicada
License	CC BY 4.0
Condición de la licencia (Recomendado-repetible)	CC BY 4.0
Derechos de acceso	acceso abierto
Access Rights	acceso abierto
Id de Web of Science	WOS:001019601700018
ISSN	0028-3878
Tipo de ruta	verde# hibrido
Categoría WOS	Neurociencias y Neurología