Coronary risk factors six to 12 months after coronary artery bypass graft surgery

Hyperlipidaemia appears to be a major factor in the development of graft atherosclerosis in the five- to 10-year period after coronary artery bypass graft surgery. A preliminary survey of coronary risk factors was conducted in 103 consecutive patients, who lived in the Sydney metropolitan area and who had undergone coronary artery bypass graft surgery six to 12 months previously in a single hospital unit. The information was collected by reply-paid questionnaire (response rate, 93%) and by clinical assessment (measurement rate, 85%). The group was predominantly (86%) male and elderly (mean age, 62 years; 60% of men and 85% of women were aged over 59 years). Seven per cent of the group had undergone a second operation. Approximately two of every three subjects manifested hypercholesterolaemia, one in four subjects manifested hypertension and one in three subjects was overweight, but only one in 20 subjects currently smoked cigarettes. The findings were compared with those in a general population sample; the assumption was made that coronary risk factors would be overrepresented in a sample of patients in whom coronary artery bypass graft surgery had been required. The data suggested that cigarette smoking was receiving appropriate intervention (before or after surgery), that hypertension was receiving some intervention, and that hyperlipidaemia was receiving insufficient intervention. On a purely empirical basis, the appropriate use of a cardiac rehabilitation service is suggested as one possible way of preventing the return of a large number of patients with graft atherosclerosis in later years.