Impact of lipid-lowering medications and low-density lipoprotein levels on 1-year clinical outcomes after coronary artery bypass grafting.

Published

Journal Article

BACKGROUND: Studies investigating lipid-lowering medication (LLM) use and LDL levels in coronary artery bypass grafting patients are limited. STUDY DESIGN: The Veterans Affairs Randomized On/Off Bypass Trial's patient records were analyzed for LLM use and 1-year LDL levels. Mortality, acute MI (AMI), and repeat revascularization rates were compared at 1 year between patients with and without LLM at discharge. In addition, AMI, repeat revascularization, and graft patency were compared between patients that did and did not achieve a 1-year LDL target level of <100 mg/dL. RESULTS: The LLM data were available for 86.4% (1,904 of 2,203) of patients. Rates of LLM use were 83.4% (1,316 of 1,577) at discharge and 90.0% (1,713 of 1,904) at 1 year. Patients discharged after coronary artery bypass grafting on LLMs had a significantly lower 1-year mortality rate (1.9% vs 5.4%; p < 0.01) than those not discharged on LLM, and 1-year AMI and repeat revascularization rates were not significantly different. Of the patients with 1-year LDL measurements, 69.4% (1,200 of 1,729) achieved an LDL target level of <100 mg/dL. No differences were seen in AMI, revascularization, or graft occlusion rates between patients who achieved target LDL levels and those who did not. CONCLUSIONS: Rates of LLM use among veterans post-coronary artery bypass grafting are high. Discharge on LLM might be associated with improved intermediate-term survival. Patients who achieved an LDL target of <100 mg/dL at 1-year did not experience improved 1-year clinical outcomes or graft patency. Longer-term follow-up might reveal differences in cardiac outcomes related to achievement of target LDL levels.

Full Text

Duke Authors

Cited Authors

  • Quin, JA; Hattler, B; Bishawi, M; Baltz, J; Gupta, S; Collins, JF; Grover, FL; McDonald, G; Shroyer, ALW

Published Date

  • September 2013

Published In

Volume / Issue

  • 217 / 3

Start / End Page

  • 452 - 460

PubMed ID

  • 23891072

Pubmed Central ID

  • 23891072

Electronic International Standard Serial Number (EISSN)

  • 1879-1190

International Standard Serial Number (ISSN)

  • 1072-7515

Digital Object Identifier (DOI)

  • 10.1016/j.jamcollsurg.2013.04.030

Language

  • eng