Increased C-Reactive Protein in Patients with Post-Stroke Depression: A Meta-analysis of Cohort Study

Alpha Psychiatry. 2024 Mar 1;25(2):124-131. doi: 10.5152/alphapsychiatry.2024.231338. eCollection 2024 Mar.

Abstract

Background: Pathophysiological mechanisms and related biological markers for post-stroke depression (PSD) are unknown. Some studies have noted that C-reactive protein (CRP) is activated in the serum of PSD patients. We aim to quantitatively summarize the concentrations of CRP in PSD patients compared to non-PSD patients.

Methods: Original studies evaluating the association between CRP and PSD were searched in 4 specific databases from the establishment of the databases to March 2023. RevMan 5.20 and Stata 11.0 statistical software were used for meta-analysis. Publication bias was tested by Egger's test. The CRP level were combined by standardized mean difference (SMD) with 95% confidence interval (CI).

Results: A total of 43 relevant literatures were retrieved, while 13 cohort studies were collected. The heterogeneity test result of the level of CRP in patients with PSD vs. non-PSD was (Q = 98.38, P < .001, I2 = 88%). The combined value of the estimated effect was [SMD = 0.34, 95% CI (0.12-0.56); P = .003]. Sensitivity analysis indicated that no study had a remarkable influence on the result of the pooled estimate. Egger's test was used to test the bias and the result was (Egger's test, P = .548), suggesting that there was no publication bias, and the results were credible. We found that different depression evaluation criteria (P = .035) and stroke types (P = .024) were considered as influencing factors for potential sources of heterogeneity.

Conclusion: In conclusion, compared to those without depressive symptoms, patients with post-stroke depression have higher concentrations of CRP in the blood.

Keywords: CRP; ischemic stroke; meta-analysis; post-stroke depression.

Publication types

  • Review

Grants and funding

The authors declared that this study has received no financial support.