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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

Korean Circulation Journal 2020년 50권 11호 p.1026 ~ 1036
김병규, 나득영, 최강운, 배준호, 이무용, 장재식, 문건웅, 이전희, 김희열, Kang Seung-Ho, 송우혁, 이성욱, 심병주, 정항재, 현민수,
소속 상세정보
김병규 ( Kim Byong-Kyu ) - Dongguk University College of Medicine Dongguk University Gyeongju Hospital Department of Internal Medicine
나득영 ( Nah Deuk-Young ) - Dongguk University College of Medicine Dongguk University Gyeongju Hospital Department of Internal Medicine
최강운 ( Choi Kang-Un ) - Dongguk University College of Medicine Dongguk University Gyeongju Hospital Department of Internal Medicine
배준호 ( Bae Jun-Ho ) - Dongguk University College of Medicine Dongguk University Gyeongju Hospital Department of Internal Medicine
이무용 ( Rhee Moo-Yong ) - Dongguk University College of Medicine Dongguk University Ilsan Hospital Department of Internal Medicine
장재식 ( Jang Jae-Sik ) - Inje University College of Medicine Inje University Busan Paik Hospital Department of Internal Medicine
문건웅 ( Moon Keon-Woong ) - Catholic University St. Vincent’s Hospital Division of Cardiology
이전희 ( Lee Jun-Hee ) - Hallym University College of Medicine Kangdong Sacred Heart Hospital Division of Cardiology
김희열 ( Kim Hee-Yeol ) - Catholic University Bucheon St. Mary’s Hospital Department of Internal Medicine
 ( Kang Seung-Ho ) - Cheju Halla General Hospital Department of Internal Medicine
송우혁 ( Song Woo-Hyuk ) - Korea University Ansan Hospital Department of Internal Medicine
이성욱 ( Lee Seung-Uk ) - Kwangju Christian Hospital Department of Internal Medicine
심병주 ( Shim Byung-Ju ) - Pohang St. Mary’s Hospital Department of Internal Medicine Division of Cardiology
정항재 ( Chung Hang-Jae ) - Pohang Semyeong Christianity Hospital Department of Internal Medicine
현민수 ( Hyon Min-Su ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine

Abstract


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.

키워드

Myocardial infarction; Percutaneous coronary intervention; Low-volume hospitals; Treatment outcome

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