Lipid Control before CABG and Its Association with In-Hospital Mortality

BACKGROUND Controlling risk factors such as dyslipidemia in patients with coronary artery disease, including candidates for coronary artery bypass grafting (CABG), is of great importance and has serious effects on CABG morbidity and mortality. The aim of this study was to evaluate lipid serum levels, comprising TG, LDL, and HDL, before CABG and their relation with in-hospital outcome. METHODS The clinical profiles of 3,593 patients in the hospital cardiac surgery databank who underwent isolated CABG between April 2006 and April 2008 were reviewed. Three components of lipid profile, including TG, LDL, and HDL serum levels, were checked at the time of hospitalization in all the patients. Lipid control was evaluated according to the published guidelines. RESULTS The mean LDL, HDL, and TG serum levels were 103.4±48.5, 40.9±16, and 168±87 mg/dl, respectively. Additionally, 487 (13.6%) patients had entire TG, LDL, and HDL serum levels within the acceptable range and in 668 (18.6%) patients, all of these components were within the uncontrolled range. After adjustment for confounders, in-hospital mortality in patients with uncontrolled TG, LDL, and HDL was higher than patients with controlled TG, LDL, and HDL (p value=0.042, OR=1.399, 95% CI =1.012-1.934). CONCLUSION The high prevalence of uncontrolled lipids in our patient population is alarming. Regular and frequent pre- and post-operative visits to monitor and modify patient risk factors, including dyslipidemia, seem necessary. An increase in statin dosage or adjunctive therapy with other lipid lowering agents may be helpful. Attempts to maintain all lipids within the controlled range may have beneficial effects on hospital outcome.