Jung Hee Lee1, Sang Yong Eom2, Ung Kim1, Chan Hee Lee1, Jang Won Son1, Dong Woon Jeon3, Jang Ho Bae4, Seok Kyu Oh5, Kwang Soo Cha6, Yongsung Suh7, Young Youp Koh8, Tae Hyun Yang9, Dae Keun Shim10, Jang Whan Bae11, Jong Seon Park12. 1. Division of Cardiovascular, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea. 2. Department of Preventive Medicine, Chungbuk National University College of Medicine, Cheongju, Korea. 3. Division of Cardiology, National Health Insurance Service (NHIS) Ilsan Hospital, Goyang, Korea. 4. Heart Center, Konyang University Hospital, Daejeon, Korea. 5. Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea. 6. Department of Internal Medicine, Pusan National University Hospital, Busan, Korea. 7. Department of Cardiology, Myongji Hospital, Goyang, Korea. 8. Division of Cardiology, Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea. 9. Department of Cardiology, Inje University Busan Paik Hospital, Busan, Korea. 10. Division of Cardiovascular, Department of Internal Medicine, Good Morning Hospital, Pyeongtaek, Korea. 11. Department of Internal Medicine, Chungbuk National University, Cheongju, Korea. drcorazon@hanmail.net, jangwhan.bae69@gmail.com. 12. Division of Cardiovascular, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea. pjs@med.yu.ac.kr.
Abstract
BACKGROUND AND OBJECTIVES: The relationship between operator volume and outcomes of percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) has not been fully investigated. We aimed to investigate the relationship between operator PCI volume and in-hospital outcomes after primary PCI for STEMI. METHODS: Among the total of 44,967 consecutive cases of PCI enrolled in the Korean nationwide, retrospective registry (K-PCI registry), 8,282 patients treated with PCI for STEMI by 373 operators were analyzed. PCI volumes above the 75th percentile (>30 cases/year), between the 75th and 25th percentile (10-30 cases/year), and below the 25th percentile (<10 cases/year) were defined as high, moderate, and low-volume operators, respectively. In-hospital outcomes including mortality, non-fatal myocardial infarction (MI), stent thrombosis, stroke, and urgent repeat PCI were analyzed. RESULTS: The average number of primary PCI cases performed by 373 operators was 22.2 in a year. In-hospital mortality after PCI for STEMI was 571 cases (6.9%). In-hospital outcomes by operator volume showed no significant differences in the death rate, cardiac death, non-fatal MI, and stent thrombosis. However, the rate of urgent repeat PCI tended to be lower in the high-volume operator (0.6%) than in the moderate-(0.7%)/low-(1.5%) volume operator groups (p=0.095). The adjusted odds ratios for adverse in-hospital outcomes were similar in the 3 groups. Multivariate analysis also showed that operator volume was not a predictor for adverse in-hospital outcomes. CONCLUSIONS: In-hospital outcomes after primary PCI for STEMI were not associated with operator volume in the K-PCI registry.
BACKGROUND AND OBJECTIVES: The relationship between operator volume and outcomes of percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) has not been fully investigated. We aimed to investigate the relationship between operator PCI volume and in-hospital outcomes after primary PCI for STEMI. METHODS: Among the total of 44,967 consecutive cases of PCI enrolled in the Korean nationwide, retrospective registry (K-PCI registry), 8,282 patients treated with PCI for STEMI by 373 operators were analyzed. PCI volumes above the 75th percentile (>30 cases/year), between the 75th and 25th percentile (10-30 cases/year), and below the 25th percentile (<10 cases/year) were defined as high, moderate, and low-volume operators, respectively. In-hospital outcomes including mortality, non-fatal myocardial infarction (MI), stent thrombosis, stroke, and urgent repeat PCI were analyzed. RESULTS: The average number of primary PCI cases performed by 373 operators was 22.2 in a year. In-hospital mortality after PCI for STEMI was 571 cases (6.9%). In-hospital outcomes by operator volume showed no significant differences in the death rate, cardiac death, non-fatal MI, and stent thrombosis. However, the rate of urgent repeat PCI tended to be lower in the high-volume operator (0.6%) than in the moderate-(0.7%)/low-(1.5%) volume operator groups (p=0.095). The adjusted odds ratios for adverse in-hospital outcomes were similar in the 3 groups. Multivariate analysis also showed that operator volume was not a predictor for adverse in-hospital outcomes. CONCLUSIONS: In-hospital outcomes after primary PCI for STEMI were not associated with operator volume in the K-PCI registry.
Authors: Arvindra Krishnamurthy; Claire M Keeble; Michelle Anderson; Natalie Burton-Wood; Kathryn Somers; Charlotte Harland; Paul D Baxter; Jim M McLenachan; Jonathan M Blaxill; Daniel J Blackman; Christopher J Malkin; Stephen B Wheatcroft; John P Greenwood Journal: Open Heart Date: 2022-10