BACKGROUND Previous studies have suggested that low operator and institutional volume may be associated with an increased risk of adverse events in patients undergoing percutaneous coronary intervention (PCI). AIMS The aim of the study was to assess the relationship between operator volume and procedure related mortality in the emergent and elective settings. METHODS Data were obtained from a national registry of PCIs, maintained in cooperation with the Association of Cardiovascular Interventions of the Polish Cardiac Society. Registry data for the period from January 2014 to December 2017 were collected. During the study, there were 162 active catheterization laboratories, in which a total of 456 732 PCIs were performed. RESULTS The median number of PCIs performed in a single laboratory was 2643.5 (interquartile range [IQR], 1875-3598.5) over 4 years. The median number of PCIs performed by a single operator was 557 (IQR, 276.25-860.5) per year. We did not confirm a significant relationship between the operator volume and mortality in the overall group of patients treated with emergency and elective PCI. However, we noted a lower mortality rate for high volume operators (odds ratio [OR], 0.79; 95% CI, 0.63-0.99; P = 0.04). When the operator volume was assessed as a continuous variable, there was a trend toward significance (OR, 0.94; 95% CI; 0.88-1.0007; P = 0.052) in patients treated with emergency PCI. CONCLUSIONS High operator volume was associated with a lower periprocedural mortality rate than low operator volume in patients undergoing PCI due to acute coronary syndromes.

Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) occurs more often in women. Aim: We sought to assess the relationship between sex and clinical outcomes during follow-up in patients after MINOCA and to identify predictors of major adverse cardiac and cerebrovascular events (MACCE). Methods: The study comprised 134 patients (78 women) at the mean age of 61.6 years, who were diagnosed with MINOCA at the Department of Cardiology between January 2015 and June 2018. The mean follow-up duration was 609.5 ± 412.2 days. Primary study endpoints were MACCE, which included all-cause death, myocardial infarction, reintervention, and cerebral stroke. Secondary endpoints were recurrent chest pain during follow-up and rehospitalisation for reasons other than MACCE. Results: Kaplan-Meier survival curve analysis did not reveal any significant differences in the frequency of MACCE (p = 0.63) or mortality rate (p = 0.29) between men and women. There was no significant impact of sex on secondary study endpoints either. Sex was not identified as a predictor of primary or secondary study endpoints in univariate or multivariate analysis. Troponin index (risk ratio [RR] 1.002; 95% confidence interval [CI] 1.0005-1.0026, p = 0.004), age (RR 1.04; 95% CI 1.008-1.065, p = 0.01), serum creatinine level (RR 1.01; 95% CI 1.001-1.01, p = 0.02), hyperlipidaemia (RR 0.26; 95% CI 0.07-0.75, p = 0.01), and prior venous thromboembolic disease (RR 8.28; 95% CI 1.15-38, p = 0.04) were found to be predictors of MACCE in multivariate analysis. Conclusions: Sex was not found to be significantly associated with clinical outcomes during the follow-up period in patients with MINOCA.

infarction (STEMI). 1,2 There are conflicting results regarding the outcomes of patients with STEMI undergoing off -hour (weekday nights, weekends, and holidays) pPCI. 1-7 Some investigators have reported higher mortality rates in that population, 1-4 while others showed no differences. 5 -7 Healthcare delivery variations, the degree of catheterization laboratory loading in the scheduled INTRODUCTION According to existing data, it has been suggested that hospital admission during the day and at night may influence the short-and long -term clinical outcomes of patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (pPCI). 1,2The majority of studies on this issue focus on patients with ST -segment elevation myocardial

Background: Patients undergoing percutaneous coronary interventions (PCI) with rotational atherectomy (RA) have massively calcified coronary arteries and their prognosis differs between sexes. Aims:The aim of the study was to evaluate the trends in the percentage of sexes in the subsequent years, to compare demographic characteristics between men and women, and to identify factors associated with the risk of periprocedural complications and death. Methods:We analyzed data on 751 113 patients treated with PCI between 2014 and 2020 from the Polish National Registry of Percutaneous Coronary Interventions (ORPKI). We extracted data on 5 177 (0.7%) patients treated with RA of whom 3 552 (68.6%) were men. To determine risk factors of periprocedural complications and death, a multivariable analysis was performed. Results:The proportion of PCIs involving RA increased between 2014 and 2020 (P <0.001). Almost twice as many RA procedures were performed on men (68.55%), and that proportion did not change in the following years. The female patients were older (75.2 [8.3] vs. 70.5 [9.2] years; P <0.001). When considering periprocedural complications, their overall rate (3.45% vs. 2.31%; P = 0.01) and death rate (0.68% vs. 0.17%; P = 0.006) were greater among women. Also, via multivariable analysis, female sex was found to be a risk factor for greater periprocedural mortality (P = 0.02) and overall complication rate (P = 0.007). 1321 Karol Sabatowski et al., Rotational atherectomy and sex w w w . j o u r n a l s . v i a m e d i c a . p l / k a r d i o l o g i a _ p o l s k a W H a t ' S n e W ?Female sex is associated with poorer clinical outcomes after percutaneous coronary interventions (Pcis) including a higher risk of death, myocardial infarction or target vessel failure, and lesion failure in long-term follow-up. Patients undergoing Pci with rotational atherectomy (ra) have massively calcified coronary arteries and differ according to sex. We aimed to assess the trends in the percentage of sexes in the years 2014-2020, to compare demographic characteristics between men and women and to identify factors associated with the risk of periprocedural complications and death. Out of 751 113 patients treated with Pci between 2014 and 2020, we extracted data on 5 177 (0.7%) patients treated with ra of whom 3 552 (68.6%) were men. Sex-related distribution of patients treated with ra was stable during the analyzed period. Multivariable regression analysis confirmed that female sex is a risk factor of periprocedural complications and mortality in patients treated with Pci and ra.

Background Low operator and institutional volume are associated with poorer procedural and long‐term clinical outcomes in the general population of patients treated with percutaneous coronary interventions (PCI). Aim To assess the relationship between operator experience and procedural outcomes of patients treated with PCI and rotational atherectomy (RA). Methods Data for conducting the current analysis were obtained from the national registry of percutaneous coronary interventions (ORPKI) maintained in cooperation with the Association of Cardiovascular Interventions (AISN) of the Polish Cardiac Society. The study covers data from January 2014 to December 2020. Results During the investigated period, there were 162 active CathLabs, at which 747,033 PCI procedures were performed by 851 operators (377 RA operators [44.3%]). Of those, 5188 were PCI with RA procedures; average 30 ± 61 per site/7 years (Me: 3; Q1–Q3: 0–31); 6 ± 18 per operator/7 years (Me: 0; Q1–Q3: 0–3). Considering the number of RA procedures annually performed by individual operators during the analyzed 7 years, the first quartile totaled (Q1: < =2.57), the second (Q2: < =5.57), and the third (Q3: < =11.57), while the fourth quartile was (Q4: > 11.57). The maximum number of procedures was 39.86 annually per operator. We demonstrated, through a nonlinear relationship with annualized operator volume and risk‐adjusted, that operators performing more PCI with RA per year (fourth quartile) have a lower number of the overall periprocedural complications (p = 0.019). Conclusions High‐volume RA operators are related to lower overall periprocedural complication occurrence in patients treated with RA in comparison to low‐volume operators.