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Many patients skip recommended medications after CABG
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Nearly half of patients who underwent CABG did not take necessary statins and aspirin afterward, according to data published in the American Journal of Cardiology.
According to the study background, an American Heart Association scientific statement gives a class IA recommendation to long-term use of statins and aspirin for secondary prevention after CABG.
“It is important for patients to understand that bypass surgery is a second chance, not a cure for their disease,” Michael P. Savage, MD, the Ralph J. Roberts Professor of Cardiology at the Sidney Kimmel Medical College at Thomas Jefferson University and director of the Angioplasty Center and Cardiac Catheterization Lab at Thomas Jefferson University Hospitals, Philadelphia, said in a press release.
Michael P. Savage
Savage and colleagues conducted a retrospective analysis of medical and electronic records of 381 consecutive patients (mean age, 69 years; 78% men) who underwent diagnostic cardiac catheterization at Thomas Jefferson University Hospital after CABG.
According to the results, 67% of patients were taking a statin, 75% aspirin and 52% both at the time of catheterization. Twenty-one percent were taking aspirin plus clopidogrel. Fifty-three percent of patients not on statin therapy had LDL 100 mg/dL or higher compared with the 26% of patients who were taking statins (P < .001).
Patency of all saphenous vein grafts occurred in 26% of those taking statin therapy and 25% of those not taking statins (P = .867). In patients on statin therapy, 46% of overall grafts were patent compared with 43% in those not taking statins (P = .517). Aspirin usage did not affect graft patency or angiographic state. Of patients taking aspirin, 46% of grafts were patent, 30% diseased and 24% occluded, with 42% of saphenous vein grafts being patent.
Revascularization with PCI or repeat CABG occurred in 62% of patients taking statins and 55% of those not taking statins (P = .224) and in 62% of patients taking aspirin and 55% of patients not taking aspirin (P = .361).
“Our study confirms the significant underutilization of both aspirin and statins in patients during long-term follow-up after bypass surgery. This suggests complacency, not only among patients, but also among health care providers regarding the need to continue appropriate prevention measures after successful heart surgery,” Savage said in the release.
Kevin Curl
“Our findings highlight the need for coordinated efforts in educating health care providers and patients to improve long-term medication usage in this high-risk population,” researcher Kevin Curl, MD, a cardiologist at Thomas Jefferson University, said in the release. – by Tracey Romero
Disclosure: The researchers report no relevant financial disclosures.
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