Changes in cholesterol levels in women after coronary artery bypass surgery

Modeling women's quality of life after cardiac events

Quality of life (QOL) is presented as a global, unidimensional, and subjective assessment of one's life. This study examined the impact of perceived health status, hope, and optimism on QOL in 93 women after suffering a cardiac event. Construct validity was examined by estimating a model where QOL was measured with four indicators, and perceived health was measured with the SF-36 Health Survey. Hope was measured with the Herth Hope Index and dispositional optimism was measured with the Life Orientation Test. The unidimensionality of QOL and its response to health status, hope, and optimism were tested. Fit indices suggested that the theoretical relations posited were compatible with the data, (chi 2(42) = 44.125, p = .382, RMSEA = .0001, GFI = .942). The model explained 66% of the variance in QOL. Modeling suggested the presence of a complex latent concept composed of hope and optimism that influenced QOL.

Lipid lowering and coronary bypass graft surgery

This article reviews the rationale for lipid lowering in patients who have coronary heart disease, and specifically for post-bypass patients. It has been well demonstrated that after coronary artery bypass graft surgery, atherosclerosis continues to progress in the native circulation and develops at an accelerated rate in saphenous vein bypass grafts. During the last decade, numerous clinical trials based on angiographic or clinical outcomes have clearly shown the beneficial effect of lipid lowering in coronary heart disease. Three trials (CLAS, post-CABG, and CARE) have demonstrated delayed progression of atherosclerosis in SVGs and/or a reduction of cardiac deaths, nonfatal MI, and the need for revascularization after lowering LDL-cholesterol. The recommended target of LDL cholesterol level of more than 100 mg/dl can be safely reached with diet and monotherapy using one of the statin drugs (HMG-CoA reductase inhibitors). Despite this widely-circulated information, there appears to be inadequate public and professional awareness of the importance of properly managing hyperlipidemia after coronary artery bypass graft surgery.

Management of dyslipidemia after coronary artery bypass grafting

The results of serial angiographic studies and intervention trials in patients after coronary artery bypass artery grafting have provided ample evidence that abnormalities of the plasma lipoprotein system are one of the most significant risk factors for a rapid atherosclerotic attrition of saphenous vein grafts. In addition to confirming the well recognized role and contribution of cholesterol-rich LDL or lipoprotein B particles to the progression of atherosclerotic lesions, intervention trials have also provided strong evidence for the atherogenic capacity of some intact and partly delipidized triglyceride-rich very low density lipoprotein and intermediate density lipoprotein (lipoprotein B complex) particles, and the protective effect of some (high density lipoprotein 3) but not all high density lipoprotein particles. Most importantly, those studies have emphasized the need for an early, aggressive treatment of dyslipoproteinemias with pharmacological agents as the most efficient therapeutic approach to delaying, if not preventing, the detrimental effect of atherosclerosis on saphenous vein grafts.