Statin Initiation Following Coronary Artery Bypass Grafting

Khanderia, Ujjaini; Townsend, Kevin; Eagle, Kim A.; Prager, Richard L.

doi:10.1378/chest.127.2.455

Cited by 18 publications

(12 citation statements)

References 34 publications

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“…In the past, appropriate clinical use of proven therapies has been observed in response to widely published, compelling clinical evidence, albeit the pace of adoption of such advances in care historically has been very slow. 17 Our data would suggest that new device use may demonstrate a different pattern, with rapid changes in practice patterns in response to partial information demonstrating newly identified risks driving broad changes in device use, only some of which are based on newly reported evidence. This theory is further supported by data from the CRUSADE and ACTION-GWTG registries, which found a similar decline in DES use, though data was limited to patients presenting with non-ST-segment elevation myocardial infarction.…”

Section: Discussionmentioning

confidence: 81%

Temporal Trends in the Use of Drug‐eluting Stents for Approved and Off‐label Indications: A Longitudinal Analysis of a Large Multicenter Percutaneous Coronary Intervention Registry

Gualano

Gurm

et al. 2010

Clinical Cardiology

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Background:We sought to examine the temporal variations in the rate of both bare-metal stent (BMS) and drug-eluting stent (DES) use for off-label indications after the reports of an increased risk of very late stent thrombosis in patients with DES at the 2006 meeting of the European Society of Cardiology (ESC). Hypothesis: To determine whether the decrease in use of DES has affected both on and off-label indications. Methods: The study cohort included patients undergoing coronary intervention in a large regional registry, the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2). Patient demographic and clinical characteristics for patients with DES in the third quarter of 2006 (pre-ESC) were compared to those from the fourth quarter of 2008 (post-guideline changes). Use of DES for off-label indications, such as STsegment elevation myocardial infarction (STEMI), in-stent restenosis (ISR), and saphenous vein graft (SVG) interventions, were evaluated. Results: The overall deployment of DES fell sharply from 83% pre-ESC to a plateau of 58% in the first quarter of 2008. This corresponded to a rise in BMS use, while angioplasty procedures stayed the same. The STEMI subgroup showed the most dramatic change, from 78% to only 36%. Off-label use in SVGs showed a similar trend, from 74% to 43%. Drug-eluting stent deployment for ISR was less affected, though it also fell 25% (from 79%-56%). Conclusions: The use of DES has fallen dramatically from June 2006 to December 2008, particularly for nonapproved indications. Our study provides a real-world assessment of contemporary change in DES use in response to the presentation of negative observational studies.

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Section: Discussionmentioning

confidence: 81%

Temporal Trends in the Use of Drug‐eluting Stents for Approved and Off‐label Indications: A Longitudinal Analysis of a Large Multicenter Percutaneous Coronary Intervention Registry

Gualano

Gurm

et al. 2010

Clinical Cardiology

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“…35, 7, 430-436 (2012) to statin therapy. 31,32 Furthermore, as pleiotropic effects have been shown to be dose dependent, 33 it is possible that high doses of statins may confer a greater protection in patients with POAF, regardless of the patients' LDL blood levels.…”

Section: Discussionmentioning

confidence: 99%

Statins Reduce Short‐ and Long‐Term Mortality Associated With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: Impact of Postoperative Atrial Fibrillation and Statin Therapy on Survival

Girerd¹,

Daleau²,

Voisine

et al. 2012

Clinical Cardiology

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Background:Postoperative atrial fibrillation (POAF) is a frequent complication of coronary artery bypass grafting (CABG) surgery. The objective of this study was to determine the impact of POAF on both short‐ and long‐term mortality following isolated CABG.Hypothesis:POAF is associated with a poorer short and long‐term mortality following CABG.Methods:We retrospectively analyzed the preoperative and operative data of 6728 consecutive patients undergoing a first isolated CABG.Results:The incidence of POAF was 27.8%. Operative mortality was higher in patients with POAF compared to those without POAF (2.3% vs 0.9%, P < 0.001). On multivariate analysis, POAF remained an independent predictor of operative mortality (odds ratio [OR]: 1.78, P = 0.01). Patients with POAF also had reduced long‐term survival (6‐year survival: 85.3% vs 89.2%, P < 0.001). After adjusting for other predictors of mortality, POAF was significantly associated with increased long‐term mortality (hazard ratio [HR]: 1.35, P = 0.04). Of note, after adjustment for potential confounders, statin treatment had a highly protective effect in POAF patients for both operative mortality (OR: 0.38, P = 0.003) and long‐term mortality (HR: 0.62, P = 0.03), whereas it had no significant effect in patients without POAF.Conclusions:POAF is an independent predictor of both short‐ and long‐term mortality following CABG. Moreover, statin therapy was independently associated with better survival in patients with POAF.Dr. Pibarot holds the Canada Research Chair in Valvular Heart Diseases, Canadian Institutes of Health Research. Dr. Mathieu is a research scholar from the Fonds de Recherches en Santé du Québec, Montreal, Canada. Dr. Després has served as a speaker for Abbott Laboratories, AstraZeneca, Solvay Pharma, GlaxoSmithKline, and Pfizer Canada Inc.; has received research funding from Eli Lilly Canada; and has served on the advisory boards of Novartis, Theratechnologies, Torrent Pharmaceuticals Ltd., and Sanofi‐Aventis. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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“…11 Another study demonstrated that patients were more likely to receive a statin after coronary artery bypass grafting once a protocol had been implemented. 12 It is interesting to note, however, that there is a lack of literature to support the use of clinical protocols to screen, diagnose, prevent, and treat chronic diseases in the solid organ transplant population. This is surprising, considering that the immunosuppression and antiinfection regimens used in this population are almost always driven by institution individualized clinical protocols.…”

Section: Discussionmentioning

confidence: 99%

Use of Bone Health Protocol to Identify and Prevent Bone Disease in Kidney and Pancreas Transplant Recipients

et al. 2007

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Statin Initiation Following Coronary Artery Bypass Grafting

Cited by 18 publications

References 34 publications

Temporal Trends in the Use of Drug‐eluting Stents for Approved and Off‐label Indications: A Longitudinal Analysis of a Large Multicenter Percutaneous Coronary Intervention Registry

Temporal Trends in the Use of Drug‐eluting Stents for Approved and Off‐label Indications: A Longitudinal Analysis of a Large Multicenter Percutaneous Coronary Intervention Registry

Statins Reduce Short‐ and Long‐Term Mortality Associated With Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: Impact of Postoperative Atrial Fibrillation and Statin Therapy on Survival

Use of Bone Health Protocol to Identify and Prevent Bone Disease in Kidney and Pancreas Transplant Recipients

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