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A multidisciplinary intervention to improve postoperative antithrombotic therapy after urgent coronary artery

Alma Feka1, Mario Verdugo-Marchese2, Sarah Hugelshofer3

  • 1Pharmacy Department, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.

Annales Pharmaceutiques Francaises
|August 8, 2025
PubMed

Insights

Implementing a new protocol improved adherence to European guidelines for postoperative antithrombotic therapy in patients after coronary artery bypass-graft surgery. This quality improvement effort showed a positive trend in adherence over time.

Area of Science:

  • Cardiology
  • Pharmacology
  • Healthcare Quality Improvement

Background:

  • Adherence to European guidelines for postoperative antithrombotic therapy is crucial for patients undergoing coronary artery bypass-graft surgery (CABG) after acute coronary syndrome (ACS).
  • Optimizing antithrombotic therapy post-CABG is essential for preventing thrombotic events while minimizing bleeding risks.

Purpose of the Study:

  • To evaluate the impact of a multidisciplinary protocol on adherence to European guidelines for postoperative antithrombotic therapy in CABG patients with ACS.
  • To assess the effectiveness of a quality improvement initiative in enhancing guideline adherence.

Main Methods:

  • A retrospective analysis of 259 patients who underwent cardiac surgery between January 2018 and December 2022.
  • Patients were divided into two groups: pre-protocol implementation (n=152) and post-protocol implementation (n=107).
  • Adherence to European guidelines for antithrombotic therapy at discharge was compared between the two groups.

Main Results:

  • Guideline adherence for postoperative antithrombotic therapy significantly increased from 58.6% in the pre-protocol group to 82.2% in the post-protocol group (P<0.001).
  • Logistic regression analysis indicated a positive, though not statistically significant, effect of the intervention after adjusting for demographic and temporal factors.
  • Adherence rates demonstrated a significant increase over time, suggesting the protocol contributed to an overall improvement trend.

Conclusions:

  • The implemented protocol demonstrated a positive association with improved adherence to European guidelines for postoperative antithrombotic therapy in ACS patients undergoing CABG.
  • While the intervention's independent effect was not statistically significant post-adjustment, it played a role in the sustained improvement of adherence.
  • The findings support the protocol's utility as part of ongoing quality improvement efforts to enhance patient care.
Abstract

Keywords:
Acute coronary syndromeCardiac surgeryChirurgie cardiaqueCoronary artery bypass-graftsDouble anti-agrégation antiplaquettairePontages aorto-coronariensSTEMISuisseSwitzerlandSyndrome coronarien aigu

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