Abstract 2324: Efficacy of Beta-Blockade and Aspirin for Secondary Prevention Following Cardiac Bypass Surgery
Background: While the acute effects of both aspirin and beta-blockade have been appreciated in in ambulatory patients and in patients undergoing surgery, their role for secondary prevention has not been studied.
Methods: Among 2,417 patients undergoing revascularization, we assessed perioperative myocardial infarction, unstable angina, serious dysrhythmia, and heart failure, their association with 7-year mortality following discharge, and the effect of secondary prevention paradigms.
Results: The occurrence of a cardiovascular event (one-of five patients) conferred a 2- to 3-fold increase in 7-year mortality (P<0.001), and among those patients, two potentially reversible associates of mortality were identified: use of aspirin or beta-blockers following the acute event and continuing long-term, reducing risk by 33% to 67% (Figure⇓). Yet, though standard in ambulatory patients, these therapies were used in only a minority of patients.
Conclusions: Secondary prevention with aspirin and beta-blockers following postoperative ischemic events substantially reduces post-discharge mortality, and should be considered in treatment paradigms.