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Ahmed A. Khattab, MD For the German Cypher Registry Investigators

Sirolimus-Eluting Stent Treatment at High-Volume Centers Confers Lower Mortality at 6-Month Follow-Up Results from the German Cypher Registry. Ahmed A. Khattab, MD For the German Cypher Registry Investigators. University Hospital Bern - Switzerland. Disclosure.

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Ahmed A. Khattab, MD For the German Cypher Registry Investigators

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  1. Sirolimus-Eluting Stent Treatmentat High-Volume Centers Confers Lower Mortality at 6-Month Follow-UpResults from the German Cypher Registry Ahmed A. Khattab, MD For the German Cypher Registry Investigators University Hospital Bern - Switzerland

  2. Disclosure • No conflict of interests for any of the authors

  3. Background (I) • PCI volume is inversely related to adverse outcome • Both for hospital and operator volumes • Threshold activity level of > 400 PCI annually for hospitals and > 75 for operators • Outcome measures include death and emergent CABG within 30 days

  4. Background (II) • DESvolume-outcome relation is not known • Volume-outcome relation beyond one month is not known

  5. Study aim To investigate the institutional SES procedural volume-6-month-outcome relation from the German Cypher Registry

  6. This analysis includes 8201 patients: 1140 (13.9%) in low-volume centers 2360 (28.8%) in intermediate-volume 4701 (57.3%) in high-volume centers The Prospective Multicenter German Cypher Registry From April 2002 - Dec. 2005 Inclusion of 12.085 patients with at least one SES Central prospective data collection in 122 german centers via Internet by IKKF Monitoring in 15 centers 91% follow-up(median 6.6 months)

  7. Tertiles definition < 150 SES patients = low volume 150 – 400 SES patients = intermediate > 400 SES patients = high-volume

  8. Baseline criteria (I)

  9. Baseline criteria (II) Baseline criteria (II)

  10. Procedural characteristics

  11. Early outcome (in-hospital)

  12. Clinical events at 6-month Follow-up

  13. Adverse clinical events at 6-month follow-up

  14. Adverse clinical events at 6-month follow-up

  15. Medication at 6-month Follow-up

  16. Conclusion • Patients receiving SES at high-volume centers have lower mortality and MI at 6 months • No difference in TVR • This association cannot be explained • Significant differences in procedural conduct were documented • The underlying etiology of death/MI cannot be defined

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