Key result
A post-discharge regimen of statins independently reduced overall and 1-year mortality after CABG, with lack of statin therapy and age predicting overall death (HR 1.1; 95% CI 1.04-1.078; P<0.001).
Why the study?
Does a discharge regimen of statin and beta-blocker therapy reduce mortality and MACE in adults after first-time isolated CABG?
Cohort (n=5,205)
Does a discharge regimen of statin and beta-blocker therapy reduce mortality and MACE in adults after first-time isolated CABG?
Hazard Ratio: 1.1 (95% CI 1.04–1.078)
p-value: p=<0.001
A post-discharge regimen of statins and beta-blockers synergistically reduces short- and long-term mortality in patients following first-time isolated CABG.
Statin therapy after CABG was associated with lower mortality; leaves open need for randomized confirmation and beta-blocker synergy.
BACKGROUND: We conducted a retrospective cohort study of patients after first-time isolated coronary artery bypass graft surgery (CABG) and assessed the impact of a discharge regimen including beta-blockers and statin therapy and their relationship to long-term all cause mortality and major adverse cardiovascular events (MACE). METHODS: We identified patients age >18 years, undergoing first time isolated CABG from 1993 to 2005. Patients were identified using the Cardiovascular Information Registry (CVIR). We collected follow-up information at 30, 60, 90 days and yearly follow-up. The registry is approved for use in research by the institutional review broad. RESULTS: We identified 5,205 patients who underwent single isolated CABG between January 1993 and December 2005. The mean age was 64.5±9.7 years and over 70% were male. There was a significant difference in the low density lipoproteins (LDL) concentration between those with or without statin medications (134±41.9 mg/dL) (no statin) vs. 126±44.8 mg/dL (with statin), P=0.001. A discharge regimen with statin therapy was associated with and overall reduction in 30 day, 1 year and long-term mortality. In addition, overall the triple ischemic endpoint of death, myocardial infarction (MI) and stroke was also significantly lower in the statin vs. no-statin group. In addition, statin and beta-blockers exerted synergistic effect on overall mortality outcomes short-term and in the long-term. We note that the predictors of overall death include no therapy with statin therapy and age [hazard ratios (HR) 1.1, 95% CI: 1.04-1.078, P<0.001] and presence of renal failure (HR 2.0, P=0.005). The estimated 11-year Kaplan Meier curves for mortality between the two groups starts to diverge immediately post discharge after single isolated CABG and continue to diverge through out the follow-up period. CONCLUSIONS: A post-discharge regimen of statins independently reduces overall and 1 year mortality. These results confirm those of earlier studies within a contemporary surgical population and support the current clinical guidelines.
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Philip et al. (2015) conducted a cohort in first-time isolated coronary artery bypass graft surgery (CABG) (n=5,205). Statin therapy vs. No statin therapy was evaluated on overall death (HR 1.1, 95% CI 1.04-1.078, p=<0.001). A post-discharge regimen of statins independently reduced overall and 1-year mortality after CABG, with lack of statin therapy and age predicting overall death (HR 1.1; 95% CI 1.04-1.078; P<0.001).
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