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Published on: March 27, 2018
Adherence to secondary prevention recommendations after coronary artery bypass graft surgery
Taya Keating1, Mohammad AlAdalieh2, Zeb Chughtai2
1Department of Cardiothoracic Surgery, Mater Misericordiae University Hospital, Dublin 7, Ireland. tayakeating@gmail.com.
Insights
Patients show good medication adherence after coronary artery bypass grafting (CABG). However, improving cardiac rehabilitation attendance and lifestyle changes are key for better secondary prevention post-CABG.
Area of Science:
- Cardiovascular Surgery
- Preventive Cardiology
- Public Health
Background:
- Secondary prevention following coronary artery bypass grafting (CABG) is crucial for long-term patient outcomes.
- Optimizing risk factor management post-CABG can reduce the incidence of adverse cardiovascular events.
Purpose of the Study:
- To evaluate adherence to secondary prevention guidelines after CABG.
- To assess risk factor modification success in patients post-CABG at a tertiary center in Ireland.
Main Methods:
- Retrospective observational study of patients who underwent CABG between 2015 and 2020.
- Data collected via phone or postal surveys on medication adherence, lifestyle factors, and cardiac rehabilitation attendance.
- Analysis of repeat interventions and risk factor control (blood pressure, cholesterol).
Main Results:
- 173 patients participated; 59% attended cardiac rehabilitation.
- High medication adherence reported: 90.2% statins, 91.3% antiplatelets, 77.4% beta-blockers, 75.7% antihypertensives.
- Smoking cessation was high (62.4%), but diet and exercise compliance were suboptimal; 16 patients had uncontrolled hypertension and 13 had hypercholesterolemia.
Conclusions:
- Medication adherence and risk factor control are generally acceptable post-CABG.
- Significant opportunities exist to improve cardiac rehabilitation uptake and lifestyle modifications for enhanced secondary prevention.
Objective:
This study was undertaken to assess and evaluate adherence to secondary prevention recommendations and risk factor modifications among a patient cohort at a single-tertiary centre in Ireland, following coronary artery bypass grafting (CABG).
Methods:
This is a retrospective observational study analysing patients who had CABG from 2015 to 2020, identified via the Adult Cardiac Surgery Database. Patients were asked a number of questions either over the phone or via postal survey, regarding blood pressure, cholesterol control, adherence to medication, attendance at cardiac-rehab and lifestyle factors. Any repeat interventions following CABG were noted.
Results:
A total of 540 patients were invited to take part in this study. One hundred seventy-three patients consented to participate, ranging from 47 to 86 years old. Postoperatively, 59% of participants attended cardiac rehab. 90.2% of patients report taking a statin, 91.3% report taking an antiplatelet, 77.4% report taking a β-blocker and 75.7% take an antihypertensive. 93.1% of patients questioned in this study reported full compliance with their daily medications. Sixteen patients continue to have hypertension despite their current regimen. Thirteen patients continue to have hypercholesterolemia despite their current prescription. 62.4% of participants have quit smoking with only 4.6% remaining current smokers. No patients required re-operation, and eight patients required stenting. Compliance with diet and exercise modifications was suboptimal.
Conclusion:
In this patient population, adherence to medication and control of risk factors is acceptable. However, there is room for improvement in terms of attendance at cardiac rehab (59%) and maintenance of a healthy lifestyle post-CABG.
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