INTRODUCTION
Coronary artery bypass surgery (CABG), which is often needed for coronary artery disease, can be a stressful experience for patients. After surgery, patients might have more pain, less relief from chest pain (angina), a higher chance of being readmitted to the hospital, a harder recovery, and a lower quality of life. Consequently, more people are interested in using complementary and alternative medicine (CAM) since they think it is cost-effective, easy to get, and does not cause many problems. Nonetheless, despite the potential benefits of CAM, patients frequently fail to inform their healthcare providers about its use, which can result in multiple problems and drug interactions. Nurses are essential in supporting patients' health; therefore, they are crucial in ensuring the safe integration of CAM and conventional medical treatments. In light of the aforementioned issues, the present study aimed to assess the prevalence of CAM use among CABG candidates and its association with patients’ demographic characteristics.

METHODS
This descriptive cross-sectional study used convenience sampling to recruit 245 patients scheduled for coronary artery bypass graft (CABG) surgery. The inclusion criteria required patients to be literate, fully oriented, and willing to participate. Data were collected using a demographic characteristic form and a complementary and alternative medicine (CAM) use assessment tool. The demographic questionnaire gathered information on age, gender, education level, marital status, income, illness duration, and surgical history. The CAM assessment explored: history of CAM use, awareness of CAM methods (including sources of knowledge), reasons for CAM use, CAM provider, perceived effectiveness of CAM, medical staff knowledge of CAM, awareness of CAM use by others, and specific CAM methods used prior to (CABG). Both instruments were validated before data collection. No missing data were observed.
Following informed written consent and explanation of the study objectives, questionnaires were administered to eligible heart patients at Seyed Al-Shohada and Taleghani Hospitals (Urmia University of Medical Sciences). The researcher clarified any questionnaire items that were unclear to participants. Participants were assured of confidentiality and informed of their right to withdraw. The data were analyzed in SPSS software (version 22) employing descriptive statistics (mean, standard deviation, number, percentage) and analytical statistics (chi-square and independent t-tests). A p-value less than 0.05 was considered statistically significant.

RESULTS
Participants (n=245) had a mean age of 62.39±10.86 years. The mean duration of heart disease was 60.23±39.51 months (approximately three years). The majority were male (65.3%; n=160), city residents (45.3%; n=111), illiterate (44.1%; n=108), married (80%; n=196), and had a monthly income below 5 million Tomans (72.7%; n=178). A history of prior surgery, primarily in the digestive area, was reported by 151(61.6%) participants. The study revealed that 88.2% (n=216) of participants used CAM for heart problems, and 60.8% (n=149) for other diseases. Participants rated CAM effectiveness as average (31.4%; n=77), and most lacked sufficient CAM knowledge (75.4%; n=184). Recommendations from relatives and acquaintances were the most common source of CAM information (33.5%; n=82), with perceived safety driving its appeal (33.9%; n=83).
The majority (52.7%; n=126) preferred CAM to be administered by medical staff. Alarmingly, most patients (76.3%; n=187) did not inform healthcare providers about their CAM use, compared to only 6.9% (n=16) who did. Among CAM modalities utilized by the participants, the most prevalent were prayer (53.5%; n=131), recreational therapy (41.6%; n=102), therapeutic diets (40%; n=98), visiting holy places (36.1%; n=88), music therapy (33.9%; n=83), exercise (30.6%; n=75), herbal medicines/vitamins (20.4%; n=50), and cupping (18%; n=44). The majority of participants reported using these modalities as complementary to conventional medicine. The current study investigated the association between personal characteristics and CAM utilization, employing Chi-square tests and independent t-tests. The results indicated that CAM use demonstrated a statistically significant relationship with both income level (P=0.002) and education level (P=0.004). No significant associations were observed between CAM use and other personal characteristics examined.

CONCLUSION
CAM is increasingly utilized and accepted across diverse populations and healthcare settings. While CAM modalities may offer perceived benefits, their use can also present potential risks, including the abandonment of conventional therapies or adverse interactions when used concurrently with established medical treatments. Consequently, it is crucial that healthcare professionals possess a comprehensive understanding of available CAM therapies, their potential benefits, and associated risks. Open and non-judgmental communication with patients regarding their use of CAM is essential, enabling providers to offer informed guidance and support. The findings of this study corroborate existing research indicating a correlation between patient demographic characteristics and CAM utilization patterns.

Ethical Considerations
Compliance with ethical guidelines
Code of Ethics of No. IR.UMSU.REC.1401.423 was obtained for this study. It should also be announced that the principles of the Declaration of Helsinki, including obtaining informed consent from the participants and the confidentiality of their information, have been observed.

Funding
This study was financially supported by Urmia University of Medical Sciences.
Authors' Contributions
Authors have played an equal role in writing this study.
Conflict of Interest
There is no conflict of interest.
Acknowledgments
We thank all the officials, staff, and patients eligible for coronary artery bypass surgery at educational and medical centers in Urmia for their sincere cooperation with the research team.