Assessing cardiovascular risk factors after coronary artery bypass surgery: value of an aggressive strategy including systematic follow-up.
BACKGROUND
Coronary revascularization surgery is a palliative treatment modality which should not preclude efforts to treat atherosclerosis.


OBJECTIVE
To assess ongoing cardiovascular risk factors after coronary artery bypass surgery and develop a strategy to attenuate such factors.


METHODS
108 patients requiring a coronary artery bypass were included: 2 died soon after surgery and 6 were excluded for personal reasons. 100 patients were re-admitted into hospital 7 months after surgery for risk factor assessment. Eight months later, they were re-contacted by telephone (systematic follow-up) for a re-assessment.


RESULTS
The population consisted of 77 men with an average age of 64+/-11 years. Prior to the operation, the known risk factors were: smoking 34%; HBP 61%; cholesterol 47%; diabetes 30%; obesity 25%. During their hospital stay six months after the procedure: 91% of the patients had at least one lipid metabolism abnormality. New-onset diabetes was diagnosed in 5%. Blood pressure was uncontrolled in 18% and 10% were still smoking. Patients tended to be putting on weight and 55% engaged in little or no physical activity. Systematic follow-up: lipid metabolism had normalized in 70% of the patients. Blood glucose levels were significantly lower. Blood pressure was uncontrolled in 9% and 4% were still smoking. Their weight had stabilized and 65% were engaging in moderate-to-strenuous physical activity.


CONCLUSIONS
Inadequate attention is paid to risk factors after coronary artery bypass surgery. A short hospital stay including a cardiovascular evaluation and education about risk factors has a positive impact on the management of atherosclerosis in the medium term.
Barandon
L
L
Département de chirurgie cardiaque, Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, Pessac. laurent.barandon@chu-bordeaux.fr
Calderon
J
J
Lafitte
M
M
Leroux
L
L
Cadusseau
J-L
JL
Roques
X
X
Couffinhal
T
T
D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D048909:Diabetes Complications / Q000150:complications* / Q000453:epidemiology; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors