Featured Poster: The depression phenotype of TIA: Prospective associations between depression and cerebrovascular disease after TIA in a population cohort study

Description of Background: Transient ischemic attack (TIA) patients are at a heightened risk of subsequent CeVD. An emerging body of literature suggests that depressive symptoms may be associated with an increased risk of cerebrovascular disease (CeVD)-related events; however, current evidence elucidating the role of depression in the development of CeVD after a TIA is lacking. We sought to investigate associations between depression and subsequent risk for CeVD in adult patients who previously suffered a TIA.

Methods: This retrospective, population cohort study examined data collected from 4,131 participants who suffered a TIA (mean age = 62.08 + 5.93, 56.9% male) before the initial UK Biobank assessment (2006-2010) and their primary care, hospital admissions, self-report, and death records through February 2023. Cox proportional hazards regression was used to identify prospective associations between baseline depression (PHQ-2 score > 2) and any category of CeVD diagnosis (ICD-10 F01, H34, G46, I60-I69).

Results:

Results: In TIA patients, baseline depression was associated with an increased risk of intracerebral hemorrhage (adjusted hazard ratio (aHR) = 4.632, 95% confidence interval (CI) = 1.981 to 10.831; p < 0.001), occlusion and stenosis of precerebral arteries (aHR = 2.736, 95% CI = 1.602 to 4.672; p < 0.001), and sequelae of CeVD (aHR = 1.544, 95% CI = 1.069 to 2.229; p < 0.020).

Conclusion: These findings suggest that depression may be a risk factor appropriate for screening TIA patients to identify those most at risk of intracerebral hemorrhage (I61), precerebral artery stenosis and occlusion (I65), and long-term disability (I69). More research is required to understand the plausible role of depression as an observable phenotype specific to emerging CeVD conditions after a TIA.

Learning Objective: To present preliminary evidence for depression after TIA as a potentially modifiable risk factor for subsequent CeVD;
To call attention to the potential of post-TIA depression screening, which is currently not routine