Carotid revascularization may lead to improved cognitive function beyond stroke prevention. This article summarizes the conclusions from available studies on the effects of carotid reperfusion procedures on cognitive function. The papers cited used different neuropsychological tests for cognitive assessment, resulting in different methodologies and the results obtained were not always convergent. However, most studies reported an improvement in neurocognitive abilities after both vascular interventions, but a more precise assessment of the specific benefits is still awaited. Clinical determinants to predict the effects of these treatments on cognitive function are still being sought, but results are not yet satisfactory. In view of these studies, carotid stenosis seems to be an independent risk factor for cognitive deterioration, and the main mechanisms responsible are embolism and cerebral hypoperfusion. The aim of this study is to order the knowledge about the effects of carotid artery stenting (CAS) and endarterectomy (CEA) on neurocognitive functions and to verify the usefulness of using these treatments.

Aim: To evaluate the incidence and severity of the impairment of selected cognitive functions in patients after sudden cardiac arrest (SCA) in comparison to patients after myocardial infarction without SCA and healthy subjects and to analyze the influence of sociodemographic and clinical...

Cel: Celem pracy była ocena częstości występowania objawów depresji i lęku u pacjentów po nagłym zatrzymaniu krążenia (NZK) w odniesieniu do osób po przebytym zawale mięśnia sercowego bez NZK i osób zdrowych. Dokonano także analizy wpływu wybranych parametrów socjodemograficznych i klinicznych oraz czasu trwania NZK na obecność i nasilenie objawów depresyjnych i lękowych w poszczególnych grupach.Metoda: W badaniu wzięło udział 30 osób po NZK i 31 osób po zawale serca bez NZK. Grupę kontrolną utworzyło 30 osób zdrowych. Do oceny stanu psychicznego użyto oryginalnie opracowanego kwestionariusza, a obecność i nasilenie badanych objawów oceniano Skalą Depresji Hamiltona (HDRS) i Skalą Lęku Hamiltona (HAMA-A).Wyniki: Wykazano istotnie statystycznie wyższy średni poziom depresji i częstsze występowanie lęku u osób po nagłym zatrzymaniu krążenia (grupa badana) i po zawale serca (grupa odniesienia) w porównaniu z grupą kontrolną. Nie zanotowano istotnych statystycznie różnic pomiędzy występowaniem lęku w grupie badanej i odniesienia. Nie wykazano wpływu czasu zatrzymania krążenia na występowanie objawów depresji i lęku w badanej grupie.Wnioski: W grupie osób po przebytym NZK najczęstszym zaburzeniem psychicznym jest depresja. Zaburzenia depresyjne i lękowe występują w grupie pacjentów po przebytym NZK istotnie częściej niż u osób zdrowych. Nie odnotowano różnic w częstości występowania i nasilenia objawów depresji u osób po NZK w porównaniu do chorych po zawale serca, którzy nie doświadczyli NZK. Opisywane wybrane parametry socjodemograficzne i kliniczne nie miały wpływu na występowanie objawów depresji i lęku w badanych grupach.

Anxiety is a common and serious problem in ischaemic heart disease. Anxiety-associated somatisation disorders may imitate symptoms of coronary artery disease or coexist with ischaemic heart disease. Despite multiple visits to various specialists, patients with somatisation are frequently misdiagnosed and therefore mistreated. Identification of patients with anxiety disorders among patients complaining of chest pain is a prerequisite for appropriate management. By its nature, coronary angiography is a diagnostic test that can give rise to anxiety. However, dynamics of anxiety in this setting may be variable depending on coexisting mental disorders. The purpose of this study was to determine whether the presence of significant atherosclerotic lesions in coronary arteries affects anxiety level changes following coronary angiography. A group of 90 female patients who underwent coronary angiography was divided into two groups: the first one included 48 patients without significant coronary stenoses, and the other one included 42 patients with confirmed significant atherosclerotic lesions. Dynamics of anxiety level changes from the hospital admission, through the post-examination period, until 6 to 9 months after coronary angiography was evaluated with three-time measurement of anxiety using the Spielberger's State-Trait Anxiety Inventory. In addition, intensity of anxiety as a trait was measured twice (at the first and the third examination). The highest intensity of anxiety as a state was noted in both groups at the first measurement. A significant reduction in anxiety was observed at the second measurement, more pronounced in the group without significant coronary lesions. At the third measurement, women with confirmed significant coronary lesions showed the lowest level of anxiety, while the level of anxiety increased compared to the second measurement in the group of patients without significant coronary lesions. At the third measurement, women without significant coronary lesions showed a significantly higher level of anxiety compared to the group with significant coronary lesions. Intensity of anxiety as a trait was significantly lower at the final measurement in the group of patients with confirmed significant coronary stenoses. In women demonstrating no significant atherosclerotic lesions in coronary angiography, anxiety does not resolve permanently but reappears after several months. In this group, is seems justified to consider a diagnosis of an anxiety disorder in the form of a somatoform disorder. Those patients should be offered psychiatric therapy.

Background: The revascularization of carotid arteries minimizes the risk of future cerebral stroke and usually improves cognitive functions. The aim of this study was to assess changes in cognitive function and verify the hypothesis assuming an improvement of selected cognitive functions—psychomotor speed, visuospatial episodic memory, executive function and verbal fluency—in patients after carotid artery stenting during a 12-month follow-up. Methods: 47 persons subject to CAS, including 13 symptomatic persons, were examined before and 12 months after a procedure with a psychological test battery (digit symbol test—DS, Rey–Osterrieth complex figure test—ROCF, Wisconsin Card Sorting Test—WCST, letter verbal fluency—LVF). Sociodemographic data and clinical parameters were acquired from an author questionnaire. Results: The one-year follow-up, after the performed CAS procedure, demonstrated a significant improvement of psychomotor speed, visuospatial episodic memory, and executive function. No changes in the area of verbal fluency or decline in any of cognitive functions under analysis were observed. Conclusions: Carotid artery stenting improves cognitive functioning, both in the area of basic and more complex cognitive functions in persons with carotid atherosclerosis.