Wou Karen, Nguyen Hiep, Duerr Robert, Del Core Michael, Fourchy Dominique, Huynh Thao, Lader Ellis, Rogers Felix J, Chaudhry Rashid, Pilote Louise, Eisenberg Mark J
Jewish General Hospital-McGill University, Center for Epidemiology and Community Studies, Suite A-118, 3755 Cote Ste. Catherine, Montreal, Quebec, Canada, H3T 1E2.
J Invasive Cardiol. 2006 Jun;18(6):278-82.
Although coronary artery bypass graft surgery (CABG) is known to reduce angina, previous studies have suggested that anti-anginal medication use is not significantly reduced after CABG. However, it is unclear how functional testing results have an impact on anti-anginal medication prescription patterns.
To determine whether post-CABG functional testing results impact prescription patterns of anti-anginal medication during the 12 months after CABG.
The Routine versus Selective Exercise Treadmill Testing after Coronary Artery Bypass Graft Surgery (ROSETTA-CABG) Registry is a prospective, multicenter study. We examined anti-anginal medication use (beta blockers, calcium channel blockers and nitrates) at discharge and at 12 months post-CABG with respect to functional testing results among 392 patients.
Among the 392 patients, 146 had at least one functional test over the 12-month follow up period. Among the 146 patients, 17% had positive functional tests, 69% had negative tests, and 14% had indeterminate tests. Both beta blocker and calcium channel blocker use did not increase from discharge to 12 months following a positive test (N = 25) (84% vs. 80%; p = NS; 16% vs. 16%; p = NS), while nitrate use increased seven-fold (4% vs. 28%; p = 0.03). However, following a negative test (N = 100), beta blocker use only decreased modestly (85% vs. 70%; p = 0.01), while both calcium channel blocker and nitrate use were unchanged (30% vs. 20%; p = NS; 4% vs. 6%; p = NS, respectively). Following an indeterminate test (N = 21), anti-anginal medication use was unchanged (p = NS for all 3 classes of medication).
The use of anti-anginal medication is only modestly reduced after CABG, and functional testing results during the first year post-CABG do not have a strong impact on prescription patterns of anti-anginal agents.
尽管冠状动脉旁路移植术（CABG）已知可减轻心绞痛，但先前的研究表明，CABG术后抗心绞痛药物的使用并未显著减少。然而，尚不清楚功能测试结果如何影响抗心绞痛药物的处方模式。
确定CABG术后功能测试结果是否会影响CABG术后12个月内抗心绞痛药物的处方模式。
冠状动脉旁路移植术后常规与选择性运动平板试验（ROSETTA-CABG）注册研究是一项前瞻性多中心研究。我们在392例患者中，根据功能测试结果，检查了CABG出院时和术后12个月时抗心绞痛药物（β受体阻滞剂、钙通道阻滞剂和硝酸盐）的使用情况。
在392例患者中，146例在12个月的随访期内至少进行了一次功能测试。在这146例患者中，17%的功能测试结果为阳性，69%为阴性，14%为不确定。功能测试结果为阳性（N = 25）的患者从出院到术后12个月，β受体阻滞剂和钙通道阻滞剂的使用均未增加（84%对80%；p = 无显著性差异；16%对16%；p = 无显著性差异），而硝酸盐的使用增加了7倍（4%对28%；p = 0.03）。然而，功能测试结果为阴性（N = 100）的患者，β受体阻滞剂的使用仅略有下降（85%对70%；p = 0.01），而钙通道阻滞剂和硝酸盐的使用均未改变（分别为30%对20%；p = 无显著性差异；4%对6%；p = 无显著性差异）。功能测试结果为不确定（N = 21）的患者，抗心绞痛药物的使用未发生变化（所有3类药物的p值均为无显著性差异）。
CABG术后抗心绞痛药物的使用仅略有减少，CABG术后第一年的功能测试结果对抗心绞痛药物的处方模式没有强烈影响。
