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Alzheimers Risk Jumps Following Bypass Surgery
Researchers say stress and trauma of surgery may be
to blame
Aug. 25, 2005 The risk of developing Alzheimers
disease increased significantly in patients who had coronary artery
bypass graft surgery or coronary angioplasty, according to a new study
by researchers from Boston University School of Medicine. The risk of AD
jumped 70 percent for those who had bypass surgery.
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The research, which appears in the current issue of
the Journal of Alzheimer's Disease (http://www.j-alz.com),
pinpoints stress and trauma of the surgery as the major cause for the
increased risk.
Led by Benjamin Wolozin, MD, PhD, professor of
pharmacology at BUSM, researchers compared 5,216 people who underwent
coronary artery bypass graft surgery (CABG) and 3,954 people who had a
percutaneous transluminal (balloon dilation) coronary angioplasty (PTCA)
in 1996 and 1997. The patients were age 55 and older and had been
treated by Veterans Affairs.
Over the course of five years, 78 of the patients
who had bypass surgery and 41 of those who had angioplasty developed
Alzheimer's disease.
"The coronary bypass patients had a 70 percent
increased risk of developing Alzheimer's disease," said Wolozin,
co-author of the study. "This increased incidence of neurocognitive
degeneration associated with heart bypass surgery provides further
incentive for more studies to better characterize the risks of cardiac
surgery on the brain."
These results suggest that patients undergoing CABG
surgery were at increased risk for the emergence of AD than those
undergoing PTCA.
According to Wolozin, previous studies show some
heart surgery patients experience memory problems immediately following
the procedure. However, at a one-year follow-up most patients regain
cognitive function.
Researchers believe this early cognitive impairment
is an immediate reaction to the stress of surgery.
"Heart bypass surgery represents a traumatic insult to the brain,
particularly by reducing oxygen supply to the brain and increasing the
stress response," said Wolozin.
"We believe that the compensation that occurs by
one year masks an underlying deficit in the central nervous system
caused by the heart surgery. As individuals age, this underlying deficit
might exacerbate progressive cognitive deficits associated with mild
cognitive impairment, a precursory phase before diagnosis of
Alzheimer's."
Wolozin and his researchers are currently working
with researchers from the Framingham Heart Study to determine if these
same observations can be duplicated in their studies.
"If these observations are confirmed, there are
measures that can be taken to protect the brain during heart bypass
surgery," explained Wolozin. "Antioxidants might offer some protection,
as well as memantine, a medication that helps slow the progression of
Alzheimer's disease. There may also be other neuroprotective agents
still in development that could shield the brain from cognitive
degeneration during and following surgery."
The article is "Assessment of the Emergence of
Alzheimer's Disease Following Coronary Artery Bypass Graft Surgery or
Percutaneous Transluminal Coronary Angioplasty" by Todd A. Lee, Benjamin
Wolozin, Kevin B. Weiss and Martin M. Bednar (Communicated by Craig
Atwood). It appears in the Journal of Alzheimer's Disease, Vol. 7,
Number 4 published by IOS Press.
About the Journal of Alzheimer's Disease
The Journal of Alzheimer's Disease (www.j-alz.com)
is an international multidisciplinary journal to facilitate progress in
understanding the etiology, pathogenesis, epidemiology, genetics,
behavior, treatment and psychology of Alzheimer's disease. The journal
publishes research reports, reviews, short communications, book reviews,
and letters-to-the-editor. The journal is dedicated to providing an open
forum for original research that will expedite our fundamental
understanding of Alzheimer's disease.
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