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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Is there improvement of "vascular depression" after carotid artery stent placement?
Wolfgang Mlekusch1, Irene Mlekusch, Erich Minar
1Department of Internal Medicine II, Vienna General Hospital, Medical School, Waehringer Guertel 18-20, A-1090 Vienna, Austria. wolfgang.mlekusch@meduniwien.ac.at
Insights
High-grade internal carotid artery stenosis is linked to depression. Carotid artery stenting (CAS) significantly reduced depressive symptoms in patients with atherosclerosis.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Psychiatry
Background:
- High-grade internal carotid artery stenosis (ICAS) is a significant risk factor for stroke.
- Depressive symptoms are common in patients with cardiovascular disease.
- The relationship between ICAS and depression requires further investigation.
Purpose of the Study:
- To determine if high-grade ICAS is associated with depressive symptoms.
- To evaluate the effect of carotid artery stenting (CAS) on depressive symptoms in patients with ICAS.
Main Methods:
- Prospective study including 143 patients with high-grade ICAS undergoing CAS and 102 controls with peripheral artery disease.
- Depressive symptoms assessed using the Beck Depression Inventory (BDI) at baseline and 4-week follow-up.
- Statistical analysis included chi-squared, Mann-Whitney U, McNemar, Wilcoxon rank sum, and two-group t tests.
Main Results:
- A higher prevalence of depressive symptoms was observed in patients with ICAS compared to controls at baseline (33.6% vs 16.7%, P = .003).
- Following CAS, a significant reduction in depressive symptoms was noted in the ICAS group (33.6% vs 9.8%, P < .001).
- Depressive symptom frequency remained unchanged in the control group (16.7% vs 13.0%, P = .1).
Conclusions:
- High-grade ICAS is associated with an increased prevalence of depressive symptoms in patients with atherosclerosis.
- Carotid artery stenting (CAS) appears to have a beneficial impact on depressive symptoms in this patient population.
- Further research may explore the mechanisms underlying this association and the therapeutic potential of CAS for depression in ICAS patients.
Purpose:
To prospectively evaluate if high-grade (> or = 80% luminal narrowing) internal carotid artery stenosis is associated with depressive symptoms and if carotid artery stent placement (CAS) potentially improves depressive symptoms.
Materials And Methods:
The study was approved by the local ethics committee, and informed consent was obtained from all subjects. One hundred forty-three patients (91 men, 52 women; interquartile range, 63-76 years) undergoing CAS because of asymptomatic high-grade (> or = 80% luminal narrowing) carotid artery stenosis and 102 control subjects (64 men, 38 women; interquartile range, 63-73 years) with advanced peripheral artery disease and without carotid artery stenosis undergoing lower-limb percutaneous transluminal angioplasty were included. Substantial depressive symptoms (defined as a Beck Depression Inventory score of 10 or higher) were recorded at baseline and at 4 weeks (follow-up) after the percutaneous procedures. The chi2 test, Mann-Whitney U test, McNemar test, Wilcoxon rank sum test, and two-group t test were used to check for statistical significance.
Results:
A significantly higher prevalence of depressive symptoms was found in patients with carotid artery stenosis than in control subjects with peripheral artery disease at baseline (33.6% vs 16.7%, P = .003). At follow-up, a significant reduction of depressive symptoms was found in patients who underwent CAS (33.6% vs 9.8%, P < .001). The frequency of depressive symptoms remained unaffected in control subjects (16.7% vs 13.0%, P = .1).
Conclusion:
High-grade carotid artery stenosis is associated with depressive symptoms in patients with atherosclerosis. CAS seems to exert beneficial effects on the course of depressive symptoms in these patients.
