Higher operator volume linked to better PCI outcomes

(HealthDay)—Higher individual operator percutaneous coronary intervention (PCI) volume is associated with better outcomes, according to a review published online June 17 in Circulation: Cardiovascular Quality and Outcomes.

Jordan B. Strom, M.D., from Massachusetts General Hospital in Boston, and colleagues conducted a systematic literature review to identify studies examining the association between operator volume and outcomes in PCI. A total of 23 studies were included, of which 14 assessed mortality, seven assessed major adverse cardiac events, and two assessed angiographic success. A random effects model was used for meta-analyses performed by outcome.

The researchers found that the studies included data for 15,907 operators performing 205,214 PCIs on 1,109,103 patients at 2,456 centers. Patients were followed for a mean of 2.8 years. Eleven of the studies were rated as higher quality. A relationship between operator volume and outcomes in PCI was more often seen for studies with higher methodological quality and those with larger sample sizes. For every threshold evaluated, higher volume was associated with improved major adverse cardiac events.

"Mortality and major adverse cardiac events increase as operator volumes decrease in PCI," the authors write. "Among studies showing a relationship, high-volume operators were defined variably, with annual PCIs ranging from >11 to >270, with no clear evidence of a threshold effect within the ranges studied."

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