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Decreasing use of preventive medication a few years after CABG

Presented by
Dr Erik Bjoerklund, Gothenburg, Sweden
ESC 2019
Data from a large Swedish registry showed that although patients who have had coronary artery bypass grafting (CABG) display a high use of preventive medications just after their operation, their use significantly declines over time.

The SWEDEHEART registry analysis included 28,812 patients who underwent isolated first-time CABG in Sweden between 2006 and 2015 and who were alive 6 months after they had been discharged. The median follow-up duration was 5 years. Six months after discharge, 93.9% of patients took statins, 91.0% took beta-blockers, 72.9% took renin-angiotensin-aldosterone system (RAAS) inhibitors and 93% took platelet inhibitors. When the data on dispensation of these drugs were assessed 8 years later, it emerged that patients took considerably less: 77.3% for statins, 76.4% for beta-blockers, 65.9% for RAAS inhibitors, and 79.8% for platelet inhibitors. Presenting the results, Dr Erik Bjoerklund (Gothenburg, Sweden) commented that he thought the reduction in prescription of preventive drugs was “alarming”. “We have to remember that the use of these drugs is associated with significantly lower relative risks of mortality.” As for the underlying reasons as to why such a huge decrease in prescription use seems to take place, he noted that a possible reason may be the fact that Swedish CABG patients are not routinely seen by cardiologists beyond 6 to 12 months after their surgery. Another reason may be attributable to the patients feeling better (as a result of CABG); hence they feel less or no need to use drugs for many years afterwards [1].

1. Bjoerklund E. SWEDEHEART - Secondary prevention medication after coronary artery bypass surgery and long-term mortality: A longitudinal population-based study from the SWEDEHEART registry. Abstract 5059. ESC Congress 2019, 31 Aug-4 Sept, Paris, France.

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