Trends in pharmacological therapy of patients referred for coronary artery bypass grafting between 2004 and 2008: a single-centre study.

BACKGROUND: Previous reports of pharmacological treatment concerning the surgical approach to coronary artery disease emphasise the underused possibilities of pharmacological treatment. AIM: To evaluate trends in the level of compliance between the pharmacological treatment administered in clinical practice and formal guidelines in patients undergoing coronary artery bypass grafting (CABG).
METHODS: For this retrospective study, medical data from 2827 consecutive patients treated in a single cardiac surgery centre from 2004 to 2008 were collected. Among them, 1253 underwent surgical procedures as isolated CABG and were enrolled in the study. The pharmacological treatment was analysed at two points of the perioperative period: the day of admission to hospital and the day of discharge from hospital. We collected information about the following groups of drugs prescribed: aspirin, b-blockers, angiotensin converting enzyme inhibitors (ACEI), statins, and sartans.
RESULTS: Before surgery, 89.78% of the total population of patients received b-blockers, 81.56% ACEI, 88.27% statins, and 3.19% sartans. After CABG, 94.48% of patients received aspirin, 96.04% b-blockers, 85.16% ACEI, 92.09% statins, and 2.14% sartans. During the years analysed, a declining trend away from preoperative prescription of b-blockers (p < 0.001), ACEI (p < 0.001), and statins (p < 0.001) was observed. In contrast, sartans (p < 0.01) were more often administered over time. At the date of discharge, the tendency to prescribe b-blockers (p < 0.05), ACEI (p < 0.001), and statins (p < 0.001) was also declining.
CONCLUSIONS: Pharmacological treatment of ischaemic heart disease in the pre- and postoperative period was underutilised. Positive changes were observed in comparison to previous reports from other countries.