이달의 kcj Hot Article / 2020년 2월
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 |
저자 |
Jung-Hee Lee, MD,1 Sang-Yong Eom, PhD,2 Ung Kim, MD,1 Chan-Hee Lee, MD,1 Jang-Won Son, MD,1 Dong Woon Jeon, MD,3 Jang-Ho Bae, MD,4 Seok Kyu Oh, MD,5 Kwang Soo Cha, MD,6 Yongsung Suh, MD,7 Young Youp Koh, MD,8 Tae-Hyun Yang, MD,9 Dae keun Shim, MD,10 Jang-Whan Bae, MD, PhD,11 and Jong-Seon Park, MD, PhD1 |
소속 |
1Division of Cardiovascular, Department of Internal Medicine, Yeungnam University Medical Center, Yeungnam University College of Medicine, Daegu, Korea.
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. |
Background and ObjectivesThe 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. MethodsAmong 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. ResultsThe 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. ConclusionsIn-hospital outcomes after primary PCI for STEMI were not associated with operator volume in the K-PCI registry. |
| | Keywords: ST elevation myocardial infarction; Percutaneous coronary intervention; Operator volume; Treatment outcome
|
본문 : https://www.e-kcj.org/DOIx.php?id=10.4070/kcj.2019.0206
|
첨부파일1 |
01.jpg (다운 20회) |