Plasma soluble triggering receptor expressed on myeloid cells 2 is associated with depression after acute ischemic stroke

BackgroundPrevious studies suggested that elevated levels of plasma soluble triggering receptor expressed on myeloid cells 2 (sTREM2) was related to increased risk of death, cardiovascular events and cognitive impairment after stroke. We aimed to prospectively investigate the association between plasma sTREM2 levels and post-stroke depression (PSD). MethodsWe measured plasma sTREM2 levels in 590 ischemic stroke patients from the China Antihypertensive Trial in Acute Ischemic Stroke. The 24-item Hamilton Rating Scale for Depression was used to assess depression at 3 months after ischemic stroke onset, and PSD was defined as a score of [≥]8. Logistic regression analysis was performed to evaluate the risk of PSD associated with plasma sTREM2 levels, and net reclassification index (NRI) and integrated discrimination improvement (IDI) were calculated to assess the predictive value of sTREM2. ResultsOf the 590 participants, 229 (38.8%) patients experienced PSD. The risk of PSD elevated significantly with plasma sTREM2 levels (P for trend=0.034). After adjusting for several covariates, the odds ratio for the highest quartile of sTREM2 compared with the lowest quartile was 2.41 (95% CI=1.35-4.31) for PSD. Multiple adjusted spline regression analysis further confirmed the linear dose-response relationship between sTREM2 levels and PSD (P for linearity=0.024). The addition of sTREM2 to a conventional model notably improved the risk prediction for PSD (category-free NRI=21.50%, 95% CI=5.92%-37.07%, P=0.011; IDI=1.43%, 95% CI=0.45%-2.42%, P=0.005). ConclusionsThe present study demonstrated that elevated plasma sTREM2 levels were associated with increased risk of PSD, suggesting that sTREM2 may be a promising prognostic biomarker for PSD. RegistrationURL: https://www.clinicaltrials.gov; Unique identifier: NCT01840072.