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Secondary prevention following coronary artery bypass grafting has improved but remains sub-optimal: the need for targeted follow-up

Lookup NU author(s): Dr Andrew Owens

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Abstract

A focused review of secondary preventive medication following revascularisation provides an opportunity to ensure optimal use of these agents. A retrospective analysis of our in-house cardiothoracic surgical database was performed to identify patients undergoing non-emergency, elective surgical revascularisation discharged on four secondary preventive medications: aspirin; beta-blockers; ACE-inhibitors and statins. Of 2749 patients studied, 2302 underwent isolated coronary artery bypass grafting (CABG), mean age 65.5 years (S.D. 9.15). Overall, 2536 (92%) patients were prescribed aspirin. Beta-blockers were prescribed in 2171 (79%) patients overall, in 1096/1360 (81%) of patients with a history of myocardial infarction and in 465/619 (75%) of patients with left ventricular systolic dysfunction (LVSD). Overall, 1518 (55%) patients were prescribed an ACE-inhibitor and 179 (6.5%) an angiotensin receptor blocker (ARB); one of these agents was prescribed in 446/619 (72%) patients with LVSD and 915/1360 (67%) patients with a history of previous myocardial infarction. Overall, 2518 (92%) patients were prescribed a statin. Secondary preventive therapies are prescribed more commonly on discharge after CABG than in previous studies, but there is a continuing under-utilisation of ACE-inhibitors. To maximise the potential benefits of these agents, further study is required to understand why they are not prescribed.


Publication metadata

Author(s): Turley AJ, Roberts AP, Morley R, Thornley AR, Owens WA, deBelder MA

Publication type: Article

Journal: Interactive CardioVascular and Thoracic Surgery

Year: 2008

Volume: 7

Issue: 2

Pages: 231-234

ISSN (print): 1569-9293

ISSN (electronic): 1569-9285

Publisher: European Association for Cardio-Thoracic Surgery

URL: http://dx.doi.org/10.1510/icvts.2007.168948

DOI: 10.1510/icvts.2007.168948

PubMed id: 18234766


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