The surgeon's role in optimizing medical therapy and maintaining compliance with secondary prevention guidelines in patients undergoing coronary artery bypass grafting

Commentary: Developing accurate tools for predicting outcomes following coronary artery bypass graft surgery: More data are needed

“…Noncompliance with GDMT following both PCI and CABG has been shown to decrease long-term survival, freedom from MI, and the need for repeat coronary revascularization procedures. 14,15 The lack of compliance with GDMT is especially detrimental for CABG patients. The beneficial advantages of CABG over PCI with 3VD and LMCAD have been found to be negated in those CABG patients who are noncompliant with GDMT.…”

“…The beneficial advantages of CABG over PCI with 3VD and LMCAD have been found to be negated in those CABG patients who are noncompliant with GDMT. 14,15 Therefore, compliance with GDMT should be factored into new scoring systems to more accurately reflect long-term mortality and MACE.…”

Commentary: Percutaneous coronary intervention for left main lesions: Once again coronary artery bypass grafting gets the shaft

“…GDMT is more likely to occur after CABG versus PCI and negates the early benefits of CABG in reducing mortality and MACE compared with PCI. 7 In view of the small number of patients presenting with acute coronary syndromes, the low-medium SYNTAX scores, and the low risk of the reported patients, it is unclear as to how these data can be used to determine the revascularization strategy in the majority of patients who present with LMD. I disagree with the authors that PCI should be regarding as a valid alternative to CABG for patients with ostial/shaft ULMCA.…”

Commentary: Guideline-directed therapy is extremely valuable, but not always current or followed

“…In this issue of the Journal, Lazar 1 has written a thoughtful review of guideline directed therapy for patients after coronary artery bypass grafting. His summary is based strongly on the American Heart Association Scientific Statement published in 2015.…”