Which lipid management strategy is associated with improved graft patency after CABG?

• A. LDL optimization pre- and postoperatively
• B. Avoid statins
• C. Increase saturated fats
• D. No lipid management needed

Answer: (A)

Lowering LDL cholesterol around the time of CABG improves graft patency by reducing the ongoing atherosclerotic and inflammatory processes that can narrow or occlude graft vessels, especially vein grafts which are particularly susceptible. Optimizing LDL before surgery helps lessen perioperative vascular stress and plaque instability, while continuing lipid-lowering therapy after surgery protects the grafts from progressive disease and restenosis over the long term. Statin therapy brings additional vascular benefits beyond lipid lowering, such as improved endothelial function and anti-inflammatory effects, which further support graft openness. In contrast, avoiding statins, increasing saturated fats, or not managing lipids at all would not promote patency and could worsen graft outcomes.