Assessing cardiovascular risk factors after coronary artery bypass surgery: value of an aggressive strategy including systematic follow-up

Arch Cardiovasc Dis. 2008 Mar;101(3):155-62. doi: 10.1016/s1875-2136(08)71797-2.

Abstract

Introduction: Coronary revascularization surgery is a palliative treatment modality which should not preclude efforts to treat atherosclerosis.

Aim: To assess ongoing cardiovascular risk factors after coronary artery bypass surgery and develop a strategy to attenuate such factors.

Methods: 108 patients requiring a coronary artery bypass were included: 2 died soon after surgery and 6 were excluded for personal reasons. 100 patients were re-admitted into hospital 7 months after surgery for risk factor assessment. Eight months later, they were re-contacted by telephone (systematic follow-up) for a re-assessment.

Results: The population consisted of 77 men with an average age of 64+/-11 years. Prior to the operation, the known risk factors were: smoking 34%; HBP 61%; cholesterol 47%; diabetes 30%; obesity 25%. During their hospital stay six months after the procedure: 91% of the patients had at least one lipid metabolism abnormality. New-onset diabetes was diagnosed in 5%. Blood pressure was uncontrolled in 18% and 10% were still smoking. Patients tended to be putting on weight and 55% engaged in little or no physical activity. Systematic follow-up: lipid metabolism had normalized in 70% of the patients. Blood glucose levels were significantly lower. Blood pressure was uncontrolled in 9% and 4% were still smoking. Their weight had stabilized and 65% were engaging in moderate-to-strenuous physical activity.

Conclusion: Inadequate attention is paid to risk factors after coronary artery bypass surgery. A short hospital stay including a cardiovascular evaluation and education about risk factors has a positive impact on the management of atherosclerosis in the medium term.

Publication types

  • Comparative Study

MeSH terms

  • Coronary Artery Bypass / methods*
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / etiology*
  • Coronary Artery Disease / surgery
  • Diabetes Complications / complications*
  • Diabetes Complications / epidemiology
  • Follow-Up Studies
  • France / epidemiology
  • Humans
  • Hypercholesterolemia / complications*
  • Hypercholesterolemia / epidemiology
  • Male
  • Middle Aged
  • Obesity / complications*
  • Obesity / epidemiology
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications
  • Prevalence
  • Prospective Studies
  • Recurrence
  • Risk Assessment
  • Risk Factors
  • Smoking / adverse effects*
  • Time Factors