Is there improvement of "vascular depression" after carotid artery stent placement?
OBJECTIVE
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.


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).


CONCLUSIONS
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.
Mlekusch
Wolfgang
W
Department of Internal Medicine II, Vienna General Hospital, Medical School, Waehringer Guertel 18-20, A-1090 Vienna, Austria. wolfgang.mlekusch@meduniwien.ac.at
Mlekusch
Irene
I
Minar
Erich
E
Haumer
Markus
M
Kopp
Christoph W
CW
Ahmadi
Ramazanali
R
Lehrner
Johannes
J
Schillinger
Martin
M
D000368:Aged; D000704:Analysis of Variance; D017130:Angioplasty; D050197:Atherosclerosis / Q000473:pathology* / Q000628:therapy*; D016893:Carotid Stenosis / Q000523:psychology* / Q000628:therapy*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000523:psychology / Q000628:therapy; D015995:Prevalence; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D015607:Stents