Patients undergoing coronary artery bypass grafting (CABG) belong to the very high-risk group of atherosclerotic cardiovascular disease. Although CABG gets advantages in relieving symptoms and improving long-term outcomes, a significant risk of cardiovascular adverse events after surgery still exists and standardized secondary prevention is needed. Lipid management plays a critical role as a secondary preventive strategy in CABG. However, lipid management of CABG patients in real clinical setting is inadequate, including lack of standardized lipid-lowering strategy, low goal attainment rate, as well as poor long-term medication adherence. In recent years, a series of clinical trials have provided a lot of groundbreaking new evidence for lipid management in patients with cardiovascular diseases which offers new strategies together with objectives of lipid-lowering and comprehensive management for patients undergoing CABG. This article reviews the strategy and research progress of lipid management after CABG, aiming to provide objective reference for clinical treatment.
The European Association for Cardio-Thoracic Surgery (EACTS) has recently updated and published the "2024 EACTS guidelines on perioperative medication in adult cardiac surgery". Based on the latest evidence, the guidelines have been updated in multiple aspects including underlying disease management, antithrombotic medication, arrhythmia treatment and other supportive care, etc. This paper aims to summarize and interpret the guidelines, in order to promote clinicians’ understanding and optimize perioperative medical treatment in adult cardiac surgery.
In May 2026, the American Heart Association (AHA) formally released the scientific statement "Secondary Prevention After Coronary Artery Bypass Graft Surgery: 2026 Update", which updates the 2015 statement. The new statement emphasizes a patient-centered shared decision-making model and further clarifies the application status of several novel drugs, including proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1a), and angiotensin receptor-neprilysin inhibitors (ARNIs), in coronary artery bypass grafting (CABG) patients with relevant indications. This article systematically summarizes and interprets the major recommendations of the statement. In conjunction with the current status of postoperative management after CABG in China, it discusses the potential applicability, implementation barriers, and future research directions of these recommendations, with the aim of providing practical guidance for cardiac surgeons and other clinicians involved in the long-term management of patients after CABG.
In March 2026, the American College of Cardiology (ACC), the American Heart Association (AHA) and other professional societies released the "Guideline on the Management of Dyslipidemia". Building on the 2018 "Guideline on the Management of Blood Cholesterol", the new guideline incorporates recent evidence from large-scale randomized cardiovascular outcome trials and contemporary risk-prediction studies. It broadens the focus of lipid management from cholesterol-centered treatment to a comprehensive, life-course management of atherogenic lipoprotein risk. For patients undergoing cardiovascular surgery, the guideline is pertinent not only for perioperative risk stratification and postoperative secondary prevention, but also offers a more sophisticated framework for long-term comprehensive management. In this article, combined with clinical guidelines and key evidence-based evidence, we interpret the major updates of the 2026 edition of the guideline and implications for cardiovascular surgical practice, with the aim of providing a reference for perioperative and long-term blood lipid management for cardiovascular surgery patients.