. Assessment of the emergence of Alzheimer's disease following coronary artery bypass graft surgery or percutaneous transluminal coronary angioplasty. J Alzheimers Dis. 2005 Aug;7(4):319-24. PubMed.

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  1. Is it possible that coronary artery bypass grafting was more likely complicated by atrial fibrillation requiring digoxin therapy in those who later developed AD?

    I refer to my previous post in which I ask whether digoxin therapy may be a risk factor for the development of AD (see ARF related news story).

    The reduced cerebral blood flow as a result of AF is also something to consider.

    I also wonder whether the release of growth factors such as PDGF is more likely increased following CABG surgery.

    View all comments by Mary Reid
  2. Rubinow et al. (1) find that amyloid fibrils bind digoxin and that this may explain the sensitivity to digitalis for some with amyloid cardiomyopathy. Does digoxin bind cerebral amyloid fibrils, and, if so, might this suggest that digoxin therapy is contraindicated for those with AD?

    It would be interesting to see whether there is an increased risk of AD for those in the Berendes et al. study (2), which reports increased digoxin levels for some critically ill patients who were not receiving treatment with cardiac glycosides.

    References:

    . Digoxin sensitivity in amyloid cardiomyopathy. Circulation. 1981 Jun;63(6):1285-8. PubMed.

    . Endogenous glycosides in critically ill patients. Crit Care Med. 2003 May;31(5):1331-7. PubMed.

    View all comments by Mary Reid

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