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Journal of the American College of Cardiology

Clinical Articles, News & Views

Medication use after CABG versus PCI

Patients who receive coronary bypass surgery (CABG) are less likely than those who receive percutaneous coronary intervention (PCI) to fill prescriptions for secondary preventive medications, and use them consistently in the first year after the procedure, according to a study1 published recently in the Journal of the American College of Cardiology.

Researchers studied patients in a large integrated healthcare delivery system who underwent CABG or PCI for new onset coronary disease. They used data from health plan databases, about prescriptions dispensed during the first year after initial coronary revascularisation, to identify patients who never filled a prescription and to calculate the medication possession ratio among patients who filled at least one prescription. They focused on angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARBs), beta-blockers, and statins.

Between 2000 and 2007, 8,837 patients with new onset coronary disease underwent initial CABG, and 14,516 underwent initial PCI. Patients receiving CABG were more likely than patients receiving PCI to not fill a prescription for a statin (7.1% vs. 4.8%, p < 0.0001) or for an ACEI/ARB (29.1% vs. 22.4%, p < 0.0001), but similar proportions never filled a prescription for a beta-blocker (6.4% vs. 6.1).

Among those who filled at least one prescription post-revascularisation, patients receiving CABG had lower medication possession ratios than patients receiving PCI for ACEI/ARBs (69.4% vs. 77.8%, p < 0.0001), beta-blockers (76.1% vs. 80.6%, p < 0.0001), and statins (82.7% vs. 84.2%, p < 0.001).


1. Hlatky MA, Solomon MD, Shilane D, Leong TK, Brindis R, Go AS. Use of medications for secondary prevention after coronary bypass surgery compared with percutaneous coronary intervention. J Am Coll Cardiol 2012.

Published on: December 20, 2012

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