J Lipid Atheroscler.
2022 May;11(2):187-196. 10.12997/jla.2022.11.2.187.
Attainment of Lipid Targets Following Coronary Artery Bypass Graft Surgery: Can We Do Better?
- Affiliations
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- 1Department of Cardiology, Fiona Stanley Hospital, Murdoch, WA, Australia
- 2Internal Medicine, Medical School, The University of Western Australia, Perth, WA, Australia
- 3Department of Cardiothoracic Surgery and Transplantation, Fiona Stanley Hospital, Murdoch, WA, Australia
- 4Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Murdoch, WA, Australia
- 5Medical School, Curtin University, Perth, WA, Australia
- 6Departments of Internal Medicine and Cardiology, Royal Perth Hospital, Perth, WA, Australia
- 7Departments of Clinical Biochemistry and Cardiovascular Genetics, PathWest Laboratory Medicine Royal Perth and Fiona Stanley Hospitals, Murdoch WA, Australia
- 8Department of Biochemistry, Clinipath Pathology, Perth, WA, Australia
- KMID: 2531856
- DOI: http://doi.org/10.12997/jla.2022.11.2.187
Abstract
Objective
Patients undergoing coronary artery bypass graft (CABG) surgery remain at high cardiovascular risk; however, few studies have evaluated lipid management and attainment of lipid targets in these patients. We investigated the proportion of CABG surgery patients who attained low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (HDL-C) targets.
Methods
Data were retrospectively obtained from patients undergoing CABG surgery at an Australian tertiary hospital between February 2015 and August 2020. The most recent lipid profile was recorded (at least 3 weeks post-operatively). We studied patients with electronically available data to ensure accuracy. Target LDL-C was defined as <1.4 (54 mg/dL) and <1.8 mmol/L (70 mg/dL), and target non-HDL-C as <2.2 (85 mg/dL) and <2.6 mmol/L (100 mg/dL), as per the 2019 and 2016 European dyslipidaemia guidelines, respectively.
Results
Follow-up lipid results were available for 484 patients (median post-operative follow-up, 483 days; interquartile range, 177.5–938.75 days). The mean age was 62.7±10.5 years and 387 (80.1%) were male. At discharge, 469 (96.9%) patients were prescribed statins, 425 (90.6%) high-intensity. Ezetimibe was prescribed for 62 (12.8%) patients and a proprotein convertase subtilisin-kexin type 9 inhibitor for 1. LDL-C levels <1.4 and <1.8 mmol/L were attained in 118 (24.4%) and 231 (47.7%) patients, respectively, and non-HDL-C levels <2.2 and <2.6 mmol/L in 140 (28.9%) and 237 (49.0%) patients, respectively.
Conclusion
The use of non-statin lipid-lowering therapies was limited, and many CABG surgery patients did not attain lipid targets despite high-intensity statins. Further studies are required to optimise lipid management in this very high-risk population.
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