Abstract
Background:Data on patient characteristics and provider practices in the management of lipids per the new guidelines in specific secondary prevention patients in the Middle East is limited.Objective:To explore patient characteristics and lipid management practices according to the new cholesterol guidelines in secondary prevention patients, up to one year following discharge for coronary artery bypass graft surgery (CABG).Methods:A retrospective chart review of patients discharged post CABG between February 2017 and February 2018 at a quaternary care centre in the Middle East. Patients were characterized by baseline demographics, comorbidities, and use of lipid lowering medications.Results:189 patients were included in the analysis. Most were diabetic (70.9%) and classified as very high risk per the ACC/AHA guidelines (84.1%) and as extremely high risk per the AACE guidelines (85.2%). Most patients (93.1%) were discharged on high intensity statin. About one third (28.6%) were never seen or only followed once within the first 2 weeks post discharge. Of those who continued to follow up beyond 3 months and within 1 year of discharge (44.4%), about half (51.2%) had follow-up lipid panels performed. Patients who followed up and were seen by a cardiologist were five times more likely to have lipid panels ordered than those seen solely by a CT surgeon. Of those with follow-up lipid panels beyond 3 months: 59.3% achieved LDL goal of <70 mg/dL and 29% achieved LDL <55 mg/dL based on their respective goals.Conclusions:Most patients undergoing CABG in a quaternary care centre in the Middle East are high risk ASCVD. Nonetheless, lipid goals are not commonly achieved nor routinely monitored. Providers will need to transition from the previous risk stratification and statin-only focused approach to adopt the most recent guidelines.
Highlights
Atherosclerotic Cardiovascular Disease (ASCVD) remains the most common cause of mortality and morbidity worldwide [1]
This study aims to explore lipid management and ASCVD patient characteristics according to the new cholesterol guidelines in secondary prevention patients up to one year following coronary artery bypass graft surgery (CABG) discharge at a quaternary care centre in the Middle East Gulf region
This study retrospectively examined the lipid management of post-CABG patients in a quaternary care centre in the Middle East, a topic and demographic with a paucity of information
Summary
Atherosclerotic Cardiovascular Disease (ASCVD) remains the most common cause of mortality and morbidity worldwide [1]. Atallah et al: Lipid Control Post Coronary Artery Bypass Graft. Long-term survival and quality of life post-CABG is compromised by the high-risk of developing atherosclerosis in native coronary arteries and bypass grafts, highlighting the importance of lipid control post-CABG. Data on patient characteristics and provider practices in the management of lipids per the new guidelines in specific secondary prevention patients in the Middle East is limited. Objective: To explore patient characteristics and lipid management practices according to the new cholesterol guidelines in secondary prevention patients, up to one year following discharge for coronary artery bypass graft surgery (CABG). Patients who followed up and were seen by a cardiologist were five times more likely to have lipid panels ordered than those seen solely by a CT surgeon. Conclusions: Most patients undergoing CABG in a quaternary care centre in the Middle East are high risk ASCVD. Providers will need to transition from the previous risk stratification and statin-only focused approach to adopt the most recent guidelines
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