The Impact of Formal Training and Certification on the Relationship Between Volume and Outcomes in Percutaneous Coronary Interventions
| Autor: | Wassef Karowni, Habib A. Dakik, Karrar Abdul-Ameer, Hani Tamim, Katia El-Sibai, Semaan Kobrossi |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Certification Percutaneous Cardiology Myocardial Infarction 030204 cardiovascular system & hematology Coronary Angiography Subspecialty 03 medical and health sciences Coronary artery bypass surgery Cardiologists Percutaneous Coronary Intervention 0302 clinical medicine Recurrence Specialty Boards Internal medicine medicine Humans Hospital Mortality cardiovascular diseases 030212 general & internal medicine Coronary Artery Bypass Fellowships and Scholarships Stroke Aged Retrospective Studies Interventional cardiology business.industry Mortality rate Retrospective cohort study Middle Aged medicine.disease Treatment Outcome Conventional PCI Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine. 17:155-160 |
| ISSN: | 1535-282X |
| Popis: | Little data are available on the impact of formal training and certification on the relationship between volumes and outcome in percutaneous coronary interventions (PCIs).The objective of this report is to study the relationship between PCI volume and outcome for a formally trained interventional cardiologist who is certified by the American Board on Internal Medicine - Interventional Cardiology subspecialty board.The operator witnessed 3 different PCI volumes/yr over a 15-year practice period (2000-2014):50 PCI/yr (years 2000-2006; n = 179), 50-100 PCI/yr (years 2007-2010; n = 256), and100 PCI/yr (years 2011-2014; n = 427). Angiographic and procedural success rates were compared between the 3 volume groups, as well as in-hospital cardiovascular events (death, recurrent myocardial infarction, repeat PCI, stroke, or coronary artery bypass surgery).The in-hospital mortality rate throughout the study period was 0.8% and was not statistically significant among the 3 volume groups. There was also no significant difference among the 3 groups with respect to recurrent myocardial infarction or repeat PCI. There was a slightly higher rate of same-stay elective coronary artery bypass grafting in the early low-volume period compared with the other 2 groups (2.2% vs. 0.8% vs. 0.2%; P = 0.04). The overall angiographic and procedural success rates were 97.3% and 96.5%, and they were not significantly different among the 3 groups.Our study shows that the angiographic and procedural success rates of PCI, as well as the in-hospital mortality, do not seem to be dependent on the annual volume for formally trained and certified interventional cardiologists. |
| Databáze: | OpenAIRE |
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