Long-term secondary cardiovascular prevention programme in patients subjected to coronary artery bypass surgery

Area of Science:

• Cardiology
• Preventive Medicine
• Health Services Research

Background:

• Patients with coronary heart disease (CHD) face a high risk of recurrent events.
• Existing evidence on secondary prevention programs is often limited to short-term or experimental settings.
• Real-world efficacy of long-term secondary prevention after coronary artery bypass surgery (CABG) requires further investigation.

Purpose of the Study:

• To assess the real-world, long-term effectiveness of a structured secondary prevention program in reducing coronary event recurrences post-CABG.
• To evaluate the impact of comprehensive secondary prevention on both symptomatic and silent coronary events.

Main Methods:

• Retrospective case-control study involving 1248 patients undergoing CABG between 2002 and 2014.
• Cases participated in a structured program (optimized treatments, adherence surveillance, lifestyle counseling); controls lived farther than 100km and received usual care.
• Matched 1:1 for gender, age, and year of CABG; data collected from electronic health records; Cox analysis used for adjusted outcomes.

Main Results:

• Program participation was associated with a significantly lower incidence of symptomatic coronary recurrences within 5 years post-CABG (HR: 0.59; 95% CI: 0.38-0.94).
• A significantly lower incidence of silent coronary recurrences was also observed in program participants (HR: 0.53; 95% CI: 0.31-0.89).

Conclusions:

• Structured, long-term secondary prevention programs significantly reduce the risk of coronary recurrences in a real-world setting.
• These programs, when added to usual cardiology care, offer meaningful protection against both symptomatic and silent cardiac events after CABG.
• The findings support the widespread implementation of such programs for improving long-term outcomes in post-CABG patients.