title: Percutaneous Coronary Intervention: Relationship Between Procedural Volume and Outcomes.
abstract: Percutaneous coronary intervention (PCI) is an integral treatment modality for acute coronary syndromes (ACS) as well as chronic stable coronary artery disease (CAD) not responsive to optimal medical therapy. This coupled with studies on the feasibility and safety of performing PCI in centers without on-site surgical backup led to widespread growth of PCI centers. However, this has been accompanied by a recent steep decline in the volume of PCIs at both the operator and hospital level, which raises concerns regarding minimal procedural volumes required to maintain necessary skills and favorable clinical outcomes. The 2011 ACC/AHA/SCAI competency statement required PCI be performed by operators with a minimal procedural volume of >75 PCIs annually at high-volume centers with >400 PCIs per year, a number which was relaxed in the 2013 ACC/AHA/SCAI update to >50 PCIs/operator/year in hospitals with >200 PCIs annually to coincide with reduction in national PCI volume. Recent data suggests that many hospitals do not meet these thresholds. We review data on the importance of volume as a vital quality metric at both an operator and hospital level in determining procedural outcomes following PCI.
authors.affiliation: Interventional Cardiology Department, The Everett Clinic, 3901 Hoyt Ave, Everett, WA, 98201, USA. abadheka@everettclinic.com.
authors.forename: Apurva O
authors.initials: AO
authors.lastname: Badheka
authors.affiliation: Cardiology Department, Borgess Medical Center, 475 W Lovell Street, Apt 102, Kalamazoo, MI, 49007, USA. drspanaich@gmail.com.
authors.forename: Sidakpal S
authors.initials: SS
authors.lastname: Panaich
authors.affiliation: Internal Medicine Department, Mount Sinai St. Luke's Roosevelt Hospital, 1111 Amsterdam Ave, New York, NY, 10025, USA. dr.shilparora@yahoo.com.
authors.forename: Shilpkumar
authors.initials: S
authors.lastname: Arora
authors.affiliation: Internal Medicine Department, Saint Peter's University Hospital, 10 Landing Lane, Apt 3N, New Brunswick, NJ, 08901, USA. drnilayvpatel@gmail.com.
authors.forename: Nilay
authors.initials: N
authors.lastname: Patel
authors.affiliation: Cardiology Department, University of Miami Miller School of Medicine, 2280 SW 32nd Ave, Apt #508, Coral Gables, Miami, FL, 33145, USA. dr.nilesh.j.patel@gmail.com.
authors.forename: Nileshkumar J
authors.initials: NJ
authors.lastname: Patel
authors.affiliation: Epidemiology Department, New York Medical College, 2854 Kennedy Blvd, Jersey City, New Jersey, 07306, USA. cnsavani237@gmail.com.
authors.forename: Chirag
authors.initials: C
authors.lastname: Savani
authors.affiliation: Cardiology Department, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. abhishek_mbbs@yahoo.com.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Deshmukh
authors.affiliation: Cardiology Department, University of Miami Miller School of Medicine, 1400 NW 12th Ave # 1179, Miami, FL, 33136, USA. MGcohen@med.miami.edu.
authors.forename: Mauricio G
authors.initials: MG
authors.lastname: Cohen
mesh_terms: D054058:Acute Coronary Syndrome / Q000601:surgery*; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D017052:Hospital Mortality; D006801:Humans; D009203:Myocardial Infarction / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000639:trends*; D016896:Treatment Outcome
keywords: Acute coronary syndromes; CAD; Operator volumes; Outcomes; PCI; Procedural volumes