title: Frequency of Use of Statins and Aspirin in Patients With Previous Coronary Artery Bypass Grafting.
abstract: Coronary artery bypass grafting (CABG) is commonly performed to treat ischemic heart disease, but long-term benefits are limited by failed patency of bypass grafts. Both statin medications and aspirin hold class I indications for all post-CABG patients and should be continued indefinitely unless contraindications exist. Unfortunately, there are limited data regarding long-term usage of these essential medications. We assessed the utilization rates of statins and aspirin among post-CABG patients referred for coronary angiography. Analysis of post-CABG patients presenting to Thomas Jefferson University for a cardiac catheterization procedure at least 3 years after surgery was performed. Inpatient and outpatient records were reviewed to assess prescribing patterns of these medications, as well as other pertinent clinical and laboratory data. The study population was 381 consecutive patients presenting at a mean of 11 ± 6 years from CABG. Mean age was 69 ± 11 years and 78% were men. A total 67% of patients were being prescribed a statin, whereas 75% were prescribed aspirin. Only 52% were prescribed both at the time of catheterization. Patients prescribed a statin had a significantly lower mean low-density lipoprotein (87 vs 106 [p <0.01]) and total cholesterol values (151 vs 162 [p <0.01]). A total of 35% of patients had low-density lipoprotein ≥100. Only 43% of saphenous vein grafts in the patients not on statin medications remained patent. In conclusion, long-term statin and aspirin use after CABG remains suboptimal despite clear guideline recommendations and clinical trial evidence of their effectiveness.
authors.affiliation: Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania. Electronic address: kevin.curl@jefferson.edu.
authors.forename: Kevin
authors.initials: K
authors.lastname: Curl
authors.affiliation: Division of Cardiology, Department of Medicine, Washington Hospital Center, Georgetown University Hospital, Washington, DC.
authors.forename: Bryan
authors.initials: B
authors.lastname: LeBude
authors.affiliation: Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Ruggiero
authors.affiliation: Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: David
authors.initials: D
authors.lastname: Fischman
authors.affiliation: Department of Cardiology, Pottstown Medical Associates, Pottstown, Pennsylvania.
authors.forename: Andrew
authors.initials: A
authors.lastname: Rose
authors.affiliation: Division of Cardiology, Department of Medicine, Emory University, Atlanta, Georgia.
authors.forename: Sulay
authors.initials: S
authors.lastname: Patel
authors.affiliation: Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: David
authors.initials: D
authors.lastname: Ogilby
authors.affiliation: Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Paul
authors.initials: P
authors.lastname: Walinsky
authors.affiliation: Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Babu
authors.initials: B
authors.lastname: Jasti
authors.affiliation: Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Michael
authors.initials: M
authors.lastname: Savage
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000628:therapy*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin