title: Lipid-lowering therapy and coronary artery bypass graft surgery:  what are the benefits?
abstract: OBJECTIVE
  Despite their apparent benefits, statins remain underutilized after coronary artery bypass graft (CABG) surgery. To summarize the literature regarding statin therapy and CABG, we performed a systematic review of the Medline database from 1987-2011 to assess the benefits of statins in CABG patients, including the role of high-dose therapy, and highlight areas for future study.
  
  
  RESULTS
  When administered prior to CABG, statins reduce the risk of perioperative mortality, stroke, and atrial fibrillation. After CABG, statins limit the progression of atherosclerosis in native coronary arteries, inhibit the process of saphenous vein graft disease, and improve vein graft patency. Furthermore, postoperative statins reduce the recurrence of cardiovascular events and improve all-cause mortality. High-intensity statin therapy early after surgery may benefit CABG patients, but this is yet to be evaluated prospectively.
  
  
  CONCLUSIONS
  Statins clearly improve the outcomes of CABG patients. In the absence of contraindications, all patients undergoing CABG are candidates for life-long statin therapy, with initiation recommended as soon as coronary disease is documented. Statins should be restarted early after surgery. However, the optimal postoperative lipid-lowering regimen remains unknown and should be the subject of upcoming trials. Strategies directed toward improving statin prescription rates and patient adherence should also be priorities for future research.
authors.affiliation: Lynn Heart and Vascular Institute, Boca Raton Regional Hospital, and Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kulik
authors.forename: Marc
authors.initials: M
authors.lastname: Ruel
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001026:Coronary Artery Bypass / Q000379:methods*; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000601:surgery*; D018450:Disease Progression; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000517:prevention & control; D009206:Myocardium; D019990:Perioperative Care; D011300:Preoperative Care; D020521:Stroke / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors