Correlation between percutaneous coronary intervention volume, door-to-balloon time and mortality of patients with
Noppadol Chamnarnphol1, Treechada Wisaratapong, Sirichai Cheevatanakornkul
1Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. cnoppado@hotmail.com
Insights
Increasing percutaneous coronary intervention (PCI) volumes, especially emergency PCI, is linked to reduced in-hospital mortality for ST-elevation myocardial infarction (STEMI) patients. Shorter door-to-balloon times also significantly decrease mortality rates.
Area of Science:
- Cardiology
- Interventional Cardiology
- Public Health
Background:
- Percutaneous coronary intervention (PCI) is the primary reperfusion therapy for ST-elevation myocardial infarction (STEMI).
- Timely PCI in high-volume centers is crucial for optimal patient outcomes.
- The relationship between PCI procedural volume and patient mortality requires further investigation.
Purpose of the Study:
- To assess the correlation between total PCI volume, emergency PCI volume, elective PCI volume, and mean door-to-balloon (DTB) time.
- To evaluate the impact of these factors on in-hospital mortality for STEMI patients undergoing emergency PCI.
Main Methods:
- Analysis of the Prince of Songkla University emergency PCI registry.
- Inclusion of STEMI patients who underwent emergency PCI from January 2007 to December 2010.
- Application of Pearson's Correlation Coefficient to determine statistical relationships.
Main Results:
- A total of 1,501 PCI procedures were performed, including 355 emergency PCIs.
- PCI volumes increased annually, while mean DTB time and in-hospital mortality decreased.
- Emergency PCI volume showed a strong negative correlation with in-hospital mortality (r = -0.953, p < 0.05).
- Mean DTB time positively correlated with in-hospital mortality (r = 0.932).
Conclusions:
- Shorter mean DTB times are associated with reduced in-hospital mortality in STEMI patients.
- Increased PCI procedural volume, particularly emergency PCI, is linked to decreased in-hospital mortality.
- Higher procedural volumes in high-volume centers may improve STEMI outcomes.
Background:
Reperfusion therapy with percutaneous coronary intervention (PCI) is the preferred method for treatment of STEMI if it can be done in a timely manner in a high volume center. The present study aimed to evaluate the correlation between total PCI volume, emergency PCI volume, elective PCI volume, mean door-to-balloon (DTB) time and in-hospital mortality of patients with STEMI treated with emergency PCI.
Material And Method:
Using Prince of Songkla university emergency PCI registry, the authors analyzed the study population of STEMI patients who underwent emergency PCI between January 2007 and December 2010. Pearson's Correlation Coefficient was used to determine the correlation.
Results:
One thousand five hundred one PCI procedures including 355 emergency PCI procedures were done during the present study period. All types of PCI volume increased in each consecutive year between 2007 and 2010 while mean DTB time and in-hospital mortality continuously declined. The mean DTB time had positive correlation (r = 0.932) with in-hospital mortality. The emergency PCI volume was strongly negatively correlated with in hospital mortality (r = -0.953) and was statistically significant. There were negative correlations of elective PCI volume (r = -0.796), total PCI volume (r = -0.848), and in-hospital mortality but the correlations were not statistically significant.
Conclusion:
For emergency PCI, shorten mean DTB time in each consecutive year was associated with lower in-hospital mortality. Regarding to procedural volume, increase in each type of PCI procedure especially emergency PCI procedure was associated with a decrease in-hospital mortality.
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