Secondary prevention of hyperlipidemia after coronary artery bypass graft: from acute care to primary care.
BACKGROUND
Clinical trials have established that secondary prevention of hyperlipidemia in patients after coronary artery bypass graft (CABG) surgery prevents progression of atherosclerosis. A multidisciplinary team promotes secondary prevention by prescribing antihyperlipidemic agents, screening for risk factors, and providing education on disease, diet, and medications. Information is minimal on the number of patients who continue with antihyperlipidemic therapy or follow-up with a primary care provider for cholesterol management after antihyperlipidemic therapy is initiated in an acute surgical setting.


OBJECTIVE
To determine (1) the frequency of use of antihyperlipidemic agents before CABG surgery, at hospital discharge, and approximately 9 months after discharge and (2) the occurrence of cholesterol monitoring by a primary care provider at least once between discharge and telephone follow-up.


METHODS
Observational study of 135 patients undergoing CABG surgery at a regional medical center during a 4-month period. Patients were contacted by telephone between 5 and 12 months after discharge and asked about continued use of antihyperlipidemic agents and cholesterol monitoring since discharge.


RESULTS
Before surgery, 56% of the patients were taking an antihyperlipidemic agent. At discharge, 95% were taking an antihyperlipidemic agent. At the time of study follow-up, 91% were still taking an antihyperlipidemic agent, and 84% had follow-up cholesterol monitoring by their primary care provider.


CONCLUSIONS
Initiation of an antihyperlipidemic agent and provision of education during hospitalization for CABG surgery results in a high percentage of patients continuing antihyperlipidemic therapy and having cholesterol levels monitored by their primary care provider after discharge.
Shenandoah University School of Pharmacy, Winchester, VA, USA.
Marcia L
ML
Brackbill
Christine
C
Sytsma
D000328:Adult; D000368:Aged; D001161:Arteriosclerosis / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000517:prevention & control*; D000960:Hypolipidemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care
D000960:Hypolipidemic Agents; D002784:Cholesterol