Korean Circ J.  2020 Feb;50(2):133-144. 10.4070/kcj.2019.0206.

Effect of Operator Volume on In-Hospital Outcomes Following Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction: Based on the 2014 Cohort of Korean Percutaneous Coronary Intervention (K-PCI) Registry

Affiliations
  • 1Division of Cardiovascular, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea. pjs@med.yu.ac.kr
  • 2Department of Preventive Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.
  • 3Division of Cardiology, National Health Insurance Service (NHIS) Ilsan Hospital, Goyang, Korea.
  • 4Heart Center, Konyang University Hospital, Daejeon, Korea.
  • 5Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.
  • 6Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
  • 7Department of Cardiology, Myongji Hospital, Goyang, Korea.
  • 8Division of Cardiology, Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea.
  • 9Department of Cardiology, Inje University Busan Paik Hospital, Busan, Korea.
  • 10Division of Cardiovascular, Department of Internal Medicine, Good Morning Hospital, Pyeongtaek, Korea.
  • 11Department of Internal Medicine, Chungbuk National University, Cheongju, Korea. drcorazon@hanmail.net

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.

Keyword

ST elevation myocardial infarction; Percutaneous coronary intervention; Operator volume; Treatment outcome

MeSH Terms

Cohort Studies*
Death
Hospital Mortality
Humans
Mortality
Multivariate Analysis
Myocardial Infarction*
Odds Ratio
Percutaneous Coronary Intervention*
Retrospective Studies
Stents
Stroke
Thrombosis
Treatment Outcome
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