Changes in cholesterol levels in women after coronary artery bypass surgery

OBJECTIVE: To examine the predictors of change in cholesterol levels in a cohort of women between the time of surgery and 1 year after coronary artery bypass graft surgery (CABG). DESIGN AND SETTING: This study was a prospective, descriptive study held at a Mid-Atlantic tertiary care medical center. METHODS: Lipid profiles, lifestyle behaviors, and other major coronary risk factors were measured at the time of surgery and again 12 months later from a consecutive convenience sample of 130 women who underwent first-lime, isolated CABG. RESULTS: The sample population was 24% black and 76% white and had a mean age of 65 years and an average of 11 years of education. Although no statistically significant changes in cholesterol levels were observed, a majority (55%) of women had increases in total cholesterol level, whereas 45% had decreased total cholesterol level between baseline and 1 year of follow-up. After controlling for preoperative cholesterol values, a change in cholesterol level was independently predicted by ejection fraction, smoking status, and body mass index. At 1 year, plasma lipoprotein levels were not optimally managed, with high proportions of values exceeding national guidelines for secondary prevention. CONCLUSIONS: Women continue to have high cholesterol levels after CABG, putting them at high risk for future coronary heart disease events. Effective secondary prevention programs targeting multiple lifestyle behaviors and adequate pharmacotherapy are needed.