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Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction

BACKGROUND: Lower primary percutaneous coronary intervention (PCI) volume is known to be associated with worse outcomes in patients with acute myocardial infarction (MI) at hospital level. The present study aimed to evaluate the relations of primary, elective, and total PCI volume and primary/total...

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Autores principales: Saito, Yuichi, Tateishi, Kazuya, Kanda, Masato, Shiko, Yuki, Kawasaki, Yohei, Kobayashi, Yoshio, Inoue, Takahiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075272/
https://www.ncbi.nlm.nih.gov/pubmed/35261284
http://dx.doi.org/10.1161/JAHA.121.023805
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author Saito, Yuichi
Tateishi, Kazuya
Kanda, Masato
Shiko, Yuki
Kawasaki, Yohei
Kobayashi, Yoshio
Inoue, Takahiro
author_facet Saito, Yuichi
Tateishi, Kazuya
Kanda, Masato
Shiko, Yuki
Kawasaki, Yohei
Kobayashi, Yoshio
Inoue, Takahiro
author_sort Saito, Yuichi
collection PubMed
description BACKGROUND: Lower primary percutaneous coronary intervention (PCI) volume is known to be associated with worse outcomes in patients with acute myocardial infarction (MI) at hospital level. The present study aimed to evaluate the relations of primary, elective, and total PCI volume and primary/total PCI volume ratio per hospital to in‐hospital mortality in patients with acute MI undergoing primary PCI. METHODS AND RESULTS: Using a large nationwide administrative database, we included a total of 83 076 patients from 154 hospitals in Japan undergoing PCI for either acute MI or elective cases. Relations of annual procedural volumes for primary, elective, and total PCI to in‐hospital mortality after acute MI at hospital level were evaluated. The ratio of primary to total PCI volume per hospital was also assessed. The primary end point was the ratio of observed to predicted mortality. Of 83 076 patients, 26 913 (32.4%) underwent primary PCI for acute MI, among whom 1561 (5.8%) died during hospitalization. Overall, observed in‐hospital mortality after acute MI and observed/predicted mortality ratio were higher in hospitals with lower primary, elective, and total PCI volumes. Observed/predicted in‐hospital mortality ratio was higher in hospitals with low primary/total PCI volume ratio, even in those with high total PCI volume. CONCLUSIONS: Primary, elective, and total PCI volume at hospitals were inversely associated with in‐hospital mortality in patients with acute MI undergoing primary PCI. Lower ratio of primary to total PCI volume were related to higher in‐hospital mortality, suggesting primary/total PCI volume ratio as an institutional indicator of quality of care for acute MI.
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spelling pubmed-90752722022-05-10 Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction Saito, Yuichi Tateishi, Kazuya Kanda, Masato Shiko, Yuki Kawasaki, Yohei Kobayashi, Yoshio Inoue, Takahiro J Am Heart Assoc Original Research BACKGROUND: Lower primary percutaneous coronary intervention (PCI) volume is known to be associated with worse outcomes in patients with acute myocardial infarction (MI) at hospital level. The present study aimed to evaluate the relations of primary, elective, and total PCI volume and primary/total PCI volume ratio per hospital to in‐hospital mortality in patients with acute MI undergoing primary PCI. METHODS AND RESULTS: Using a large nationwide administrative database, we included a total of 83 076 patients from 154 hospitals in Japan undergoing PCI for either acute MI or elective cases. Relations of annual procedural volumes for primary, elective, and total PCI to in‐hospital mortality after acute MI at hospital level were evaluated. The ratio of primary to total PCI volume per hospital was also assessed. The primary end point was the ratio of observed to predicted mortality. Of 83 076 patients, 26 913 (32.4%) underwent primary PCI for acute MI, among whom 1561 (5.8%) died during hospitalization. Overall, observed in‐hospital mortality after acute MI and observed/predicted mortality ratio were higher in hospitals with lower primary, elective, and total PCI volumes. Observed/predicted in‐hospital mortality ratio was higher in hospitals with low primary/total PCI volume ratio, even in those with high total PCI volume. CONCLUSIONS: Primary, elective, and total PCI volume at hospitals were inversely associated with in‐hospital mortality in patients with acute MI undergoing primary PCI. Lower ratio of primary to total PCI volume were related to higher in‐hospital mortality, suggesting primary/total PCI volume ratio as an institutional indicator of quality of care for acute MI. John Wiley and Sons Inc. 2022-03-09 /pmc/articles/PMC9075272/ /pubmed/35261284 http://dx.doi.org/10.1161/JAHA.121.023805 Text en © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Saito, Yuichi
Tateishi, Kazuya
Kanda, Masato
Shiko, Yuki
Kawasaki, Yohei
Kobayashi, Yoshio
Inoue, Takahiro
Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction
title Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction
title_full Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction
title_fullStr Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction
title_full_unstemmed Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction
title_short Volume‐Outcome Relationships for Percutaneous Coronary Intervention in Acute Myocardial Infarction
title_sort volume‐outcome relationships for percutaneous coronary intervention in acute myocardial infarction
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075272/
https://www.ncbi.nlm.nih.gov/pubmed/35261284
http://dx.doi.org/10.1161/JAHA.121.023805
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