The Unrecognized Patient and Economic Burdens of Post Coronary Artery Bypass Grafting Surgery Morbidities: Could Contemporary Medical Therapy Play a Bigger Role?

Abstract

Abbreviations AF: Atrial Fibrillation BARI 2D: the Bypass Angioplasty Revascularization Investigation 2 Diabetes CABG: Coronary Artery Bypass Grafting CASS: Coronary Artery Surgery Study DALYs: Disability Adjusted Life Years MASS II: the second Medical, Angioplasty, or Surgery Study MT: Medical Therapy STICH: Surgical Treatment for Ischemic Heart Failure American Research Journal of Cardiovascular Diseases ISSN-2575-7601 Volume 3, Issue 1, 13 pages Research Article Open Access The Unrecognized Patient and Economic Burdens of Post Coronary Artery Bypass Grafting Surgery Morbidities: Could Contemporary Medical Therapy Play a Bigger Role? Abolfazl Dohaei, M.D.1, Wayne L. Miller, M.D., Ph.D.1 Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, United States of America. Dohaei.Abolfazl@mayo.edu Abstract Background: The recognition of the impact of new medications and the synergic effect of new drug combinations is absent in studies comparing coronary artery bypass grafting surgery (CABG) with medical therapy. There are limited review data regarding the contribution of morbidities after CABG on outcomes. Methods: Full texts and data were collected from Mayo Clinic library, PubMed, and Google Scholar sources. We reviewed all pertinent article texts and study designs and identified relevant studies. Because we intended to include all morbidity results, we gathered all systematic reviews relating to specific morbidities and provided a comprehensive explanation of results. Published articles were assessed from 1994 up to the present time considering contemporary studies regarding morbidities. Results: The impact of morbidities and economic costs after CABG go unrecognized in the decision process to pursue CABG while the beneficial effects of newer medications on managing ischemia and cardiovascular outcomes are potentially undervalued. Conclusions: Considering new medications in the light of the deleterious impact of morbidities and costs following CABG should prompt needed studies to evaluate in a more comprehensive manner the impact of coronary surgical revascularization vs. contemporary medical therapy. Condensed Abstract: The impact of morbidities and costs after CABG is significant. New studies comparing CABG with MT based on advances in contemporary medications relative to the morbidities and costs following CABG are needed.