Impact of functional testing results on prescription patterns of anti-anginal medication after coronary artery bypass graft surgery: results from the ROSETTA-CABG Registry.
BACKGROUND
Although coronary artery bypass graft surgery (CABG) is known to reduce angina, previous studies have suggested that anti-anginal medication use is not significantly reduced after CABG. However, it is unclear how functional testing results have an impact on anti-anginal medication prescription patterns.


OBJECTIVE
To determine whether post-CABG functional testing results impact prescription patterns of anti-anginal medication during the 12 months after CABG.


METHODS
The Routine versus Selective Exercise Treadmill Testing after Coronary Artery Bypass Graft Surgery (ROSETTA-CABG) Registry is a prospective, multicenter study. We examined anti-anginal medication use (beta blockers, calcium channel blockers and nitrates) at discharge and at 12 months post-CABG with respect to functional testing results among 392 patients.


RESULTS
Among the 392 patients, 146 had at least one functional test over the 12-month follow up period. Among the 146 patients, 17% had positive functional tests, 69% had negative tests, and 14% had indeterminate tests. Both beta blocker and calcium channel blocker use did not increase from discharge to 12 months following a positive test (N = 25) (84% vs. 80%; p = NS; 16% vs. 16%; p = NS), while nitrate use increased seven-fold (4% vs. 28%; p = 0.03). However, following a negative test (N = 100), beta blocker use only decreased modestly (85% vs. 70%; p = 0.01), while both calcium channel blocker and nitrate use were unchanged (30% vs. 20%; p = NS; 4% vs. 6%; p = NS, respectively). Following an indeterminate test (N = 21), anti-anginal medication use was unchanged (p = NS for all 3 classes of medication).


CONCLUSIONS
The use of anti-anginal medication is only modestly reduced after CABG, and functional testing results during the first year post-CABG do not have a strong impact on prescription patterns of anti-anginal agents.
Jewish General Hospital-McGill University, Center for Epidemiology and Community Studies, Suite A-118, 3755 Cote Ste. Catherine, Montreal, Quebec, Canada, H3T 1E2. meisenberg@epid.jgh.mcgill.ca.
Wou
Karen
K
Nguyen
Hiep
H
Duerr
Robert
R
Del Core
Michael
M
Fourchy
Dominique
D
Huynh
Thao
T
Lader
Ellis
E
Rogers
Felix J
FJ
Chaudhry
Rashid
R
Pilote
Louise
L
Eisenberg
Mark J
MJ
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002309:Cardiology / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009574:Nitro Compounds / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012042:Registries / Q000706:statistics & numerical data
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D009574:Nitro Compounds