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Updated: Jun 21, 2026
04:30
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Sirolimus-eluting stent treatment at high-volume centers confers lower mortality at 6-month follow-up: results from
Ahmed A Khattab1, Christian W Hamm, Jochen Senges
1Herz-Kreislauf-Zentrum, Segeberger Kliniken GmbH, Bad Segeberg, Germany. ahmed.khattab@insel.ch
Circulation
|August 5, 2009
Summary
Higher sirolimus-eluting stent procedural volume in hospitals is linked to better patient outcomes, reducing death and heart attack rates. This highlights the importance of high-volume centers for patient safety and care.
Area of Science:
- Cardiology
- Interventional Cardiology
- Health Services Research
Background:
- Percutaneous coronary intervention (PCI) procedural volume is a known predictor of patient outcomes.
- High-volume centers are typically defined as performing >400 PCI procedures annually.
- The impact of drug-eluting stent (DES) procedural volume on outcomes remains under investigation.
Purpose of the Study:
- To investigate the relationship between sirolimus-eluting stent (SES) procedural volume at the institutional level and patient outcomes.
- To determine if higher procedural volumes in centers correlate with improved safety and efficacy of SES implantation.
Main Methods:
- Analysis of 8201 patients treated with SES from April 2002 to September 2005 in 51 German centers.
- Centers categorized into low (<150), intermediate (150-400), and high (>400 SES patients) volume groups.
- Primary endpoint: composite of all-cause death, myocardial infarction, and target-vessel revascularization at 6 months.
Main Results:
- The composite endpoint occurred in 11.3% (low), 12.1% (intermediate), and 9.0% (high) of patients (P=0.0001).
- High-volume centers showed a significantly lower rate of death/myocardial infarction compared to low- and intermediate-volume centers, even after risk adjustment.
- No significant difference in target-vessel revascularization or cerebrovascular accidents between volume groups.
Conclusions:
- Institutional sirolimus-eluting stent procedural volume is inversely associated with death and myocardial infarction at 6 months.
- High-volume centers appear to offer better safety outcomes for SES procedures.
- Findings suggest significant public health policy implications regarding center specialization and patient referral patterns.
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