Pharmacotherapy in patients undergoing CABG: Difference between revisions

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=== Primary Prevention Adults 40 to 75 Years of Age With LDL-C Levels 70 to 189 mg/dL (1.7 to 4.8 mmol/L) ===
== 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization (Please do not edit). Pharmacotherapy in patients undergoing CABG ==
 
=== Insulin Infusion and Other Measures to Reduce Sternal Wound Infection in Patients Undergoing CABG ===
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| colspan="1" style="text-align:center; background:LightGreen" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
| colspan="1" style="text-align:center; background:LightGreen" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
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| bgcolor="LightGreen" |<nowiki>"</nowiki>'''1.''' In adults at intermediate-risk, statin therapy reduces risk of ASCVD, and in the context of a risk discussion, if a decision is made for statin therapy, a moderate-intensity statin should be recommended ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen" |<nowiki>"</nowiki>'''1.''' In patients undergoing CABG, an intraoperative continuous insulin infusion should be initiated to maintain serum glucose level <180 mg/dL to reduce sternal wound infection''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
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| bgcolor="LightGreen" |<nowiki>"</nowiki>'''2.''' In intermediate-risk patients, LDL-C levels should be reduced by 30% or more, and for optimal ASCVD risk reduction, especially in high-risk patients, levels should be reduced by 50% or more. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen" |<nowiki>"</nowiki>'''2.''' In patients undergoing CABG, the use of continuous intravenous insulin to achieve and maintain an early postoperative blood glucose concentration of <180 mg/dL while avoiding hypoglycemia is indicated to reduce the incidence of adverse events, including deep sternal wound infection. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-R]])'' <nowiki>"</nowiki>
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| bgcolor="LightGreen" |<nowiki>"</nowiki>'''3.''' For the primary prevention of clinical ASCVD* in adults 40 to 75 years of age without diabetes mellitus and with an LDL-C level of 70 to 189 mg/dL (1.7 to 4.8 mmol/L), the 10-year ASCVD risk of a first “hard” ASCVD event (fatal and nonfatal MI or stroke) should be estimated by using the race- and sex-specific PCE, and adults should be categorized as being at low risk (<5%), borderline risk (5% to <7.5%), intermediate-risk (≥7.5% to <20%), and high-risk (≥20%)''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen" |<nowiki>"</nowiki>'''3.''' In patients undergoing CABG, a comprehensive approach to reducing sternal wound infections is recommended''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B-NR]])'' <nowiki>"</nowiki>
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<ref name="pmid35286170">{{cite journal| author=| title=Correction to: 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 11 | pages= e771 | pmid=35286170 | doi=10.1161/CIR.0000000000001061 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35286170  }}</ref>
 
 
 
 
 
== References ==

Revision as of 12:57, 6 December 2022

2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization (Please do not edit). Pharmacotherapy in patients undergoing CABG

Insulin Infusion and Other Measures to Reduce Sternal Wound Infection in Patients Undergoing CABG

Class I
"1. In patients undergoing CABG, an intraoperative continuous insulin infusion should be initiated to maintain serum glucose level <180 mg/dL to reduce sternal wound infection(Level of Evidence: B-R) "
"2. In patients undergoing CABG, the use of continuous intravenous insulin to achieve and maintain an early postoperative blood glucose concentration of <180 mg/dL while avoiding hypoglycemia is indicated to reduce the incidence of adverse events, including deep sternal wound infection. (Level of Evidence: B-R) "
"3. In patients undergoing CABG, a comprehensive approach to reducing sternal wound infections is recommended(Level of Evidence: B-NR) "

[1]



References

  1. ↑ "Correction to: 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (11): e771. 2022. doi:10.1161/CIR.0000000000001061. PMID 35286170 Check |pmid= value (help).
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