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Nov 14, 2019

Medications Boost Survival After Open Heart Surgery

Study confirms benefits of blood pressure, cholesterol and anti-clotting medications after open heart surgery. 

Most heart medications prove critical after open heart surgery, based on a recent study linking blood thinners, cholesterol and blood pressure medications to improved survival after coronary artery bypass grafting.

Published in the European Heart Journal, this study compared medication use and survival rates among patients after open heart surgery. The goal was to see how many patients received recommended therapies after surgery and how medication use impacted outcomes.

Open heart surgery—formally known as coronary artery bypass grafting or CABG—helps improve blood flow to the heart when arteries are narrowed or blocked. It’s a tried-and-true treatment for heart disease and helps reduce risk for future heart events. However, medications like blood thinners and statins are strongly recommended after surgery to prevent complications and improve survival.

To explore the rates and impact of medication use after CABG, experts analyzed data from Swedish registries that track hospitalizations, prescription use and mortality.

Researchers focused on key medications including cholesterol-lowering drugs (statins), blood pressure-lowering medications (beta blockers and renin–angiotensin–aldosterone system inhibitors like ACE inhibitors and ARBs), and blood thinners (platelet inhibitors). All three types of drugs are recommended after CABG and help reduce risk for heart events and other complications.

In total, the study included 28,812 adults that underwent open heart surgery between 2006 and 2015 and were followed for up to nine years.

Not surprisingly, analysis confirmed the long-term benefits of medication use among CABG patients. Individuals taking statins had 44% lower risk of death than those not taking statins, and blood thinners reduced risk of death by 26%. Blood pressure medications like ACE inhibitors and ARBs were also associated with a reduction in mortality risk, although beta blockers had no significant effect on outcomes.

The good news is that most patients were prescribed these drugs after open heart surgery, as guidelines suggest. Data showed that more than 90% of patients received recommended cholesterol, blood pressure and anti-clotting medications in the six months after their procedure. However, as little as two-thirds of participants were still taking these medications after eight years of follow-up.

The take-home message, according to authors, is the importance of medication use after CABG. It’s well established that cholesterol, blood pressure and anti-clotting drugs help improve outcomes after open heart surgery. Findings suggest that continued use of these medications could reduce risk of death by as much as 44%.

With 9 out of 10 CABG patients receiving recommended therapies, data from the Swedish registry is promising. However, experts note that improving medication adherence—particularly in the long term—may be an important next step for boosting survival and outcomes.

Questions for You to Consider

  • What is coronary artery bypass grafting?
  • Coronary artery bypass grafting (CABG) is a surgical procedure used to treat coronary artery disease, or the build-up of plaque in the heart’s arteries. During CABG, a healthy artery or vein is connected to a blocked artery in the heart to divert blood and improve blood flow.
  • Who needs coronary artery bypass grafting?
  • Coronary artery bypass grafting (CABG) is used to treat people with severe coronary artery disease. CABG is often recommended when other treatments like lifestyle changes and medications don’t work. CABG may also be recommended if there is significant blockage of the arteries that requires immediate treatment. Doctors can determine whether a patient with coronary artery disease is a candidate for CABG based on a physical exam and other tests.

Infographic: Medication Adherence


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