First AHA scientific statement on post-CABG secondary prevention since 2015, published in Circulation in the week after HF26. Covers lipid lowering (including PCSK9 inhibitors / inclisiran in this population), antiplatelet/anticoagulation, BP targets, diabetes and CKM management, cardiac rehabilitation, and post-discharge follow-up — separating evidence-based from consensus recommendations throughout. Reference document for the multidisciplinary CABG follow-up team.
Coronary artery bypass grafting is a well-established, durable, and safe surgical intervention. However, coronary artery disease continues to progress after the procedure. Patients who have undergone bypass surgery present unique challenges in terms of secondary prevention resulting from the often severe and diffuse nature of their coronary disease, the complexities of their postoperative recovery, the burden of their comorbid conditions, and the importance of ensuring long-term graft patency and preventing further disease progression. New evidence and advances in secondary prevention strategies in the post–coronary bypass grafting population have emerged since the American Heart Association's 2015 scientific statement on this topic. This 2026 update revisits lipid lowering, antiplatelet/anticoagulation strategies, blood-pressure targets, diabetes and CKM management, cardiac rehabilitation, and post-discharge follow-up structures, with an emphasis on what is evidence-based and what is consensus-driven. Secondary prevention strongly correlates with improved outcomes after bypass surgery, providing the rationale and urgency for this updated scientific statement to promote evidence-based practical considerations and to improve their use.
