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[Prognosis and risk evaluation of postoperative coronary patients (PERISCOP). Methodology and study population
P Sellier1, G Chatellier, C Dubois
1Service de réadaptation cardiaque, hôpital Broussais, 96, rue Didot, 75014 Paris.
Insights
Cardiology tests after coronary bypass surgery predict one-year cardiac events. Lipid management improved cholesterol levels, but targets were not consistently met, indicating a need for better lipid abnormality treatment post-surgery.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Preventive Cardiology
Context:
- Post-coronary bypass surgery (CABG) care requires robust risk stratification.
- Evaluating the effectiveness of routine cardiological investigations is crucial for patient outcomes.
- Managing dyslipidemia post-CABG is essential for secondary prevention.
Purpose:
- To assess the predictive value of post-CABG cardiological investigations for one-year cardiac events and mortality.
- To analyze the management and effectiveness of lipid-lowering therapies in patients after CABG.
- To describe the methodology and baseline characteristics of patients in the PERISCOP study.
Summary:
- The PERISCOP study prospectively enrolled 2065 patients (86% male, mean age 63.1 years) post-CABG.
- Cardiological investigations (stress testing, Holter, echocardiography) were performed around 20 days post-surgery.
- Abnormal findings included positive stress tests (9%), ventricular arrhythmias (6.5%), and suboptimal lipid control (46% achieved LDL < 1 g/L with treatment).
Impact:
- Findings will inform clinical practice regarding the utility of routine post-CABG cardiac assessments.
- Highlights the challenges in achieving therapeutic lipid targets in post-CABG patients.
- Provides baseline data for future research on optimizing cardiovascular risk management after bypass surgery.
Abstract:
The aim of the PERISCOP study was to evaluate the predictive value of cardiological investigations performed after recent coronary bypass surgery with regards to cardiac event and mortality at one year. The treatment of lipid abnormalities was also analysed. This first article describes the methodology and patient characteristics at inclusion. This prospective national multicenter trial included 2065 patients (86% men) with an average age of 63.1 +/- 9.9 years. The number of diseased vessels was 2.6 +/- 0.6. Preoperative left ventricular function was normal (ejection fraction 60 +/- 13%). Revascularisation was complete in 73% of cases (22% of arterial grafts). The cardiological investigations were performed at Day 20 +/- 10 after surgery. The duration of exercise on stress testing was 429 +/- 170 seconds. It was positive or doubtful in 9% of cases. Ventricular arrhythmias were observed in 6.5% of cases. The blood pressure response was abnormal in 6% of cases. Holter monitoring showed a median number of ventricular extrasystoles over 24 hours of 44. Three per cent of patients had one episode of ventricular tachycardia and 7% had ischaemic episodes. The echocardiographic index of segmental contractility was on average 1.75 (ejection fraction: 52.6%). The lipid analysis performed at one month, under lipid therapy in 34% of cases, showed a total cholesterol level at 1.91 +/- 0.10 g/l, an LDL-cholesterol of 1.27 +/- 0.08 g/l. The therapeutic target (LDL-cholesterol < 1 g/l) was attained in 46% of cases with treatment and in 18% of cases without treatment.
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