XU Xiaoyu 1 , ZHANG Zehua 1 , JIA Tianyu 2 , SONG Bangrong 2 , DONG Ran 2 , LIN Yang 1
  • 1. Department of Pharmacy, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, P. R. China;
  • 2. Department of Coronary Heart Disease Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, P. R. China;
LIN Yang, Email: linyang3623@163.com
Coronary artery bypass grafting; lipid management; lipid-lowering drug; low-density lipoprotein cholesterol
10.7507/1007-4848.202503092
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Objective To understand the current status of low-density lipoprotein cholesterol (LDL-C) control in patients after coronary artery bypass grafting. Methods Clinical data of patients who underwent isolated coronary artery bypass grafting in Beijing Anzhen Hospital in 2023 were collected. All patients returned to our hospital approximately one year after surgery (10-13 months) for a lipid level recheck. We analyzed their LDL-C attainment status and influencing factors. Patients were categorized into two groups based on whether their LDL-C met the target: the LDL-C attainment group and the LDL-C non-attainment group. Results This study included 1456 patients who had undergone coronary artery bypass grafting, including 320 females and 1136 males, with an average age of (61.41±9.12) years. One year post-surgery, 234 patients achieved the LDL-C target, with an attainment rate of 16.07%. The proportion of patients in the LDL-C attainment group who were ultra-high risk (77.35% vs. 92.06%, P＜0.001), female (16.24% vs. 23.08%, P=0.021), and those with comorbid hypertension (55.98% vs. 63.18%, P=0.038) was significantly lower than those in the LDL-C non-attainment group. Additionally, the baseline body mass index (BMI) upon admission in the attainment group [(25.37±3.24) kg/m2 vs. (26.03±3.56) kg/m2, P=0.017], total cholesterol levels [(3.30±0.84) mmol/L vs. (4.01±1.03) mmol/L, P＜0.001], LDL-C [(1.62±0.62) mmol/L vs. (2.25±0.85) mmol/L, P＜0.001], and high-density lipoprotein cholesterol [(0.98±0.26) mmol/L vs. (1.02±0.24) mmol/L, P=0.049] were all lower than in the non-attainment group. Moreover, the lipid-lowering drug usage rate in the attainment group (100.00% vs. 96.24%, P=0.003) and the proportion using two types of drugs together (25.21% vs. 10.72%, P＜0.001) were both higher than in the non-attainment group, while the statin monotherapy rate was lower than in the non-attainment group (74.79% vs. 85.19%, P＜0.001). Logistic regression analysis showed that baseline BMI (OR=0.928, P=0.012) and baseline LDL-C levels (OR=0.207, P<0.001), patient cardiovascular risk stratification (OR=0.155, P<0.001) and lipid-lowering drug treatment regimen (OR=3.758, P<0.001) are significant factors affecting whether LDL-C meets the standard. Conclusion The LDL-C compliance rate of patients undergoing coronary artery bypass grafting is at a relatively low level 1 year after surgery. Patients with very high risk of atherosclerotic cardiovascular disease, high baseline LDL-C levels, and overweight or obesity should strengthen their lipid management. For these patients, the intensity of lipid-lowering drug use or combination medication should be increased upon discharge.

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