Post-CABG guidelines directed medical therapy: Assessing compliance at Peshawar Institute of Cardiology.

Abstract

Objective: To determine the post-operative compliance with guideline directed medications following coronary artery by-pass grafting. Study Design: Retrospective Observational study. Setting: Peshawar Institute of Cardiology, KPK. Period: December 2020 to December 2023. Methods: This study included (n=2146) adults who underwent CABG surgery and their GDMT compliance was observed. Data was extracted from electronic medical record (EMR) and was evaluated by using SPSS version 26.0. Results: The mean age of the patients (56.821±10.1548) and mean BMI (27.8249±4.32135). Percentage of Guideline directed medical therapy utilization after coronary artery bypass grafting showed beta-blockers 97%, statin 95%, aspirin+clopidogrel to be 99%, aspirin 82%, ACEI 9% and CCB 5%. Multivariate regression model for secondary prevention in CABG, the rate of GDMT use, such as aspirin, showed a significant relationship with age (p < 0.05), while gender showed non significant relationship with GDMT use. Similarly, aspirin, CCB, and ACEI showed a significant relationship with family history (p < 0.05). Conclusion: The study underscores post-operative compliance with discharge medications following coronary artery bypass grafting (CABG). The findings revealed varying levels of adherence to guideline-directed medical therapies (GDMT), with several patients not fully complying with prescribed medications such as statins, beta-blockers, and aspirin.