Use of cardiovascular medical therapy among patients undergoing coronary artery bypass graft surgery: Results from the ROSETTA-CABG Registry

Okrainec, Karen; Pilote, Louise; Platt, Robert W.; Eisenberg, Mark J.

doi:10.1016/s0828-282x(06)70302-6

Cited by 21 publications

(17 citation statements)

References 30 publications

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“…The Routine versus Selective Exercise Treadmill Testing after Coronary Artery Bypass Graft Surgery (ROSETTA-CABG) study, a prospective registry of post-CABG surgery patients, also investigated the use of secondary prevention CV medications at discharge and 1 year after surgery. 6 This study demonstrated much lower rates of utilization for each class of medication at discharge (range 30-92%) and at 1 year after surgery (38-87%) compared with the present study. The lowest rate of utilization was for ACEIs at roughly 30% and 38%, respectively, at discharge and 1 year after surgery.…”

Section: Discussioncontrasting

confidence: 73%

“…Multiple studies from health records and registry data have demonstrated that the utilization rates of secondary prevention CV medications after CABG surgery are generally low with wide variability (30-97%). [3][4][5][6][7] Furthermore, it has been demonstrated that patients taking 50% or less of the four classes of indicated medications at discharge, compared with those taking all four medications, had a 1.7-fold higher rate of death or myocardial infarction (MI) at 2 years. 5 Therefore, strategies aimed at improving utilization of these medications after CABG surgery are essential to reduce the risk of future CV events and improve overall survival.…”

mentioning

confidence: 99%

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Evaluation of Preventive Cardiovascular Pharmacotherapy after Coronary Artery Bypass Graft Surgery

Barry¹,

Koshman

Norris

et al. 2013

Pharmacotherapy

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The utilization rate for patients receiving all four classes of secondary prevention cardiovascular medications was 35% at discharge and 48% at 1 year after CABG surgery. These rates were primarily limited by the low utilization of angiotensin-modulating agents, although their rate improved by 22% from discharge. Utilization rates, however, were high for aspirin, β-blockers, and statins both at discharge and 1 year after surgery. Opportunities remain to further optimize secondary prevention cardiovascular pharmacotherapy in patients who undergo CABG surgery, either while in the hospital or immediately subsequent to discharge.

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Section: Discussioncontrasting

confidence: 73%

mentioning

confidence: 99%

Evaluation of Preventive Cardiovascular Pharmacotherapy after Coronary Artery Bypass Graft Surgery

Barry¹,

Koshman

Norris

et al. 2013

Pharmacotherapy

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“…[4][5][6][7] Notwithstanding these benefits, adherence to preventative medical therapy after CABG remains low. 3,8,9 Poor adherence to evidence-based medications leads to a rise in healthcare costs 17 and significantly increases the risk of MI and death after CABG.…”

Section: Discussionmentioning

confidence: 99%

“…3,8,9 Recently published, the Post-Myocardial Infarction Free Rx and Economic Evaluation (MI FREEE) trial assessed the impact of eliminating patient copayments for preventive medications after hospitalization for MI. 14 In this secondary analysis of the MI FREEE trial, we sought to evaluate the relative effectiveness of providing full prescription coverage, compared with usual prescription coverage, for patients treated with or without CABG after recent MI.…”

Section: S220 Circulationmentioning

confidence: 99%

Full Prescription Coverage Versus Usual Prescription Coverage After Coronary Artery Bypass Graft Surgery

et al. 2013

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Background— Eliminating out-of-pocket costs for patients after myocardial infarction (MI) improves adherence to preventive therapies and reduces clinical events. Because adherence to medical therapy is low among patients treated with coronary artery bypass graft surgery (CABG), we evaluated the impact of providing full prescription coverage to this patient subgroup. Methods and Results— The MI Free Rx Event and Economic Evaluation (FREEE) trial randomly assigned 5855 patients with MI to full prescription coverage or usual formulary coverage for all statins, β-blockers, angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers. We assessed the impact of full prescription coverage on adherence, clinical outcomes, and healthcare costs using adjusted models among the 1052 patients who underwent CABG at the index hospitalization and 4803 who did not. CABG patients were older and had more comorbid illness ( P <0.01). After MI, CABG patients were significantly more likely to receive β-blockers and statins but were less likely to receive angiotensin-converting enzyme inhibitor/angiotensin receptor blocker therapy ( P <0.01). Receiving full drug coverage increased rates of adherence to all preventative medications after CABG (all P <0.05). Full coverage was also associated with nonsignificant reductions in the rate of major vascular events or revascularization for patients treated with CABG (hazard ratio, 0.91; 95% confidence interval, 0.66–1.25) or without CABG (hazard ratio, 0.93; 95% confidence interval, 0.82–1.06), with no interaction noted ( P int =NS). After CABG, full prescription coverage significantly reduced patient out-of-pocket spending for drugs ( P =0.001) without increasing overall health expenditures ( P =NS). Conclusions— Eliminating drug copayments after MI provides consistent benefits to patients treated with or without CABG, leading to increased medication adherence, trends toward improved clinical outcomes, and reduced patient out-of-pocket expenses.

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“…On the other hand, Coronary Artery Bypass Graft (CABG) surgery has been demonstrated in both observational and randomized trials to prolong survival in those patients [1]. Despite the benefi ts of CABG surgery, 15% to 25% of patients develop graft closure within one year following the procedure [2]. Furthermore, the patency rate of grafts mainly predicts both the short-and long-term benefi t from CABG surgery [3].…”

Section: Introductionmentioning

confidence: 99%

Significant Restenosis of Multiple Saphenous Vein Grafts Early After Coronary Artery Bypass Graft Surgery: a Case Report

Cicek¹

2011

J Med Cases

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Use of cardiovascular medical therapy among patients undergoing coronary artery bypass graft surgery: Results from the ROSETTA-CABG Registry

Cited by 21 publications

References 30 publications

Evaluation of Preventive Cardiovascular Pharmacotherapy after Coronary Artery Bypass Graft Surgery

Evaluation of Preventive Cardiovascular Pharmacotherapy after Coronary Artery Bypass Graft Surgery

Full Prescription Coverage Versus Usual Prescription Coverage After Coronary Artery Bypass Graft Surgery

Significant Restenosis of Multiple Saphenous Vein Grafts Early After Coronary Artery Bypass Graft Surgery: a Case Report

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