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KMID : 0368120200500111026
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Korean Circulation Journal
2020 Volume.50 No. 11 p.1026 ~ p.1036
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Impact of Hospital Volume of Percutaneous Coronary Intervention (PCI) on In-Hospital Outcomes in Patients with Acute Myocardial Infarction: Based on the 2014 Cohort of the Korean Percutaneous Coronary Intervention (K-PCI) Registry
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Kim Byong-Kyu
Nah Deuk-Young
Choi Kang-Un
Bae Jun-Ho
Rhee Moo-Yong
Jang Jae-Sik
Moon Keon-Woong
Lee Jun-Hee
Kim Hee-Yeol
Kang Seung-Ho
Song Woo-Hyuk
Lee Seung-Uk
Shim Byung-Ju
Chung Hang-Jae
Hyon Min-Su
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Abstract
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Background and Objectives: The relationship between the hospital percutaneous coronary intervention (PCI) volumes and the in-hospital clinical outcomes of patients with acute myocardial infarction (AMI) remains the subject of debate. This study aimed to determine whether the in-hospital clinical outcomes of patients with AMI in Korea are significantly associated with hospital PCI volumes.
Methods: We selected and analyzed 17,121 cases of AMI, that is, 8,839 cases of non-ST-segment elevation myocardial infarction and 8,282 cases of ST-segment elevation myocardial infarction, enrolled in the 2014 Korean percutaneous coronary intervention (K-PCI) registry. Patients were divided into 2 groups according to hospital annual PCI volume, that is, to a high-volume group (≥400/year) or a low-volume group (<400/year). Major adverse cardiovascular and cerebrovascular events (MACCEs) were defined as composites of death, cardiac death, non-fatal myocardial infarction (MI), stent thrombosis, stroke, and need for urgent PCI during index admission after PCI.
Results: Rates of MACCE and non-fatal MI were higher in the low-volume group than in the high-volume group (MACCE: 10.9% vs. 8.6%, p=0.001; non-fatal MI: 4.8% vs. 2.6%, p=0.001, respectively). Multivariate regression analysis showed PCI volume did not independently predict MACCE.
Conclusions: Hospital PCI volume was not found to be an independent predictor of in-hospital clinical outcomes in patients with AMI included in the 2014 K-PCI registry.
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KEYWORD
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Myocardial infarction, Percutaneous coronary intervention, Low-volume hospitals, Treatment outcome
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