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Review
. 2020 Nov;35(6):664-672.
doi: 10.1097/HCO.0000000000000783.

Secondary prevention after CABG: do new agents change the paradigm?

Amélie Paquin  1   2 , Paul Poirier  1   3 , Jonathan Beaudoin  1   2 , Marie-Eve Piché  1   2
Affiliations
Review

Secondary prevention after CABG: do new agents change the paradigm?

Amélie Paquin et al. Curr Opin Cardiol. 2020 Nov.

Abstract

Purpose of review: Coronary artery bypass graft (CABG) surgery remains the gold-standard treatment for multivessel and left main coronary artery disease. Despite significant improvement in cardiovascular outcomes, patients undergoing CABG remain at risk for recurrent adverse ischemic events and other cardiovascular outcomes (coronary revascularisation, stroke, cardiac death, etc.). The purpose of this review is to summarize the most recent evidence in pharmacological preventive therapies addressing the residual cardiovascular risk in patients who have undergone CABG.

Recent findings: Novel cardiovascular pharmacological preventive strategies targeting inflammatory, metabolic and prothrombotic (antiplatelet and anticoagulation) pathways have been recently assessed, with promising results for secondary prevention after CABG.

Summary: Secondary prevention is an essential part of postoperative care after CABG. Novel lipid-lowering and glucose-controlling agents suggest a strong and consistent benefit on native coronary artery disease and overall cardiovascular outcomes. The role and the choice of enhanced antiplatelet/anticoagulation/lipid/glucose-modulating therapies following CABG should be better defined and deserves further investigation. Additional studies are required to identify new therapeutic target addressing the specific multifactorial nature of the graft CV disease and identifying the best preventive strategies for long-term graft patency.

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References

    1. Sousa-Uva M, Head SJ, Milojevic M, et al. 2017 EACTS Guidelines on perioperative medication in adult cardiac surgery. Eur J Cardiothorac Surg 2018; 53:5–33.
    1. Kulik A, Ruel M, Jneid H, et al. Secondary prevention after coronary artery bypass graft surgery: a scientific statement from the American Heart Association. Circulation 2015; 131:927–964.
    1. Gaudino M, Antoniades C, Benedetto U, et al. Mechanisms, consequences, and prevention of coronary graft failure. Circulation 2017; 136:1749–1764.
    1. Caliskan E, de Souza DR, Boning A, et al. Saphenous vein grafts in contemporary coronary artery bypass graft surgery. Nat Rev Cardiol 2020; 17:155–169.
    1. de Vries MR, Simons KH, Jukema JW, et al. Vein graft failure: from pathophysiology to clinical outcomes. Nat Rev Cardiol 2016; 13:451–470.

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