CORONARY ARTERY SURGERY: Edited by Marc RuelSecondary prevention after CABG: do new agents change the paradigm?Paquin, Améliea,b; Poirier, Paula,c; Beaudoin, Jonathana,b; Piché, Marie-Evea,bAuthor Information aInstitut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval bDepartment of Medicine, Faculty of Medicine cDepartment of Pharmacy, Faculty of Pharmacy, Université Laval, Québec, QC, Canada Correspondence to Marie-Eve Piché, MD, PhD, FRCPC, Institut Universitaire de Cardiologie et de Pneumologie de Québec-Université Laval, 2725 Chemin Sainte-Foy, Québec, QC, Canada, G1V 4G5. Tel: +1 418 656 4767; fax: +1 418 656 4581; e-mail: [email protected] Current Opinion in Cardiology: November 2020 - Volume 35 - Issue 6 - p 664-672 doi: 10.1097/HCO.0000000000000783 Buy Metrics Abstract Purpose of review Coronary artery bypass graft (CABG) surgery remains the gold-standard treatment for multivessel and left main coronary artery disease. Despite significant improvement in cardiovascular outcomes, patients undergoing CABG remain at risk for recurrent adverse ischemic events and other cardiovascular outcomes (coronary revascularisation, stroke, cardiac death, etc.). The purpose of this review is to summarize the most recent evidence in pharmacological preventive therapies addressing the residual cardiovascular risk in patients who have undergone CABG. Recent findings Novel cardiovascular pharmacological preventive strategies targeting inflammatory, metabolic and prothrombotic (antiplatelet and anticoagulation) pathways have been recently assessed, with promising results for secondary prevention after CABG. Summary Secondary prevention is an essential part of postoperative care after CABG. Novel lipid-lowering and glucose-controlling agents suggest a strong and consistent benefit on native coronary artery disease and overall cardiovascular outcomes. The role and the choice of enhanced antiplatelet/anticoagulation/lipid/glucose-modulating therapies following CABG should be better defined and deserves further investigation. Additional studies are required to identify new therapeutic target addressing the specific multifactorial nature of the graft CV disease and identifying the best preventive strategies for long-term graft patency. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.