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.

The process of apoptosis in the postovulatory cumulus granulosa cells was investigated in pregnant rats. Mature female Wistar rats, exhibiting a regular 4-day oestrous cycle, were placed with males on the day of pro-oestrus. The following day, on which spermatozoa were found in vaginal smears, was designated day 1 of pregnancy. The animals were killed just before ovulation (24.00 hours), on days 1 (5.00, 11.00, and 18.00 hours), and 2 ( 11.00 hours) of pregnancy. Excised ovaries and oviducts were submitted to a routine histological procedure and paraplast sections were subjected to detection of apoptotic cells using the TUNEL method. The cumulus granulosa cells of preovulatory follicles (24.00 hours) were negative for apoptotic staining. However, 5 h later a positive staining was observed in the oviduct ampulla and included the cumulus granulosa cells lying in the peripheral parts of postovulatory cumuli oophori, and the oviductal epithelial cells of this region. On the evening of day 1 almost all cumulus granulosa cells showed strong immunostaining while on day 2 at 11.00 hours only immunonegative clusters of remnants of cumulus granulosa cells were present in the distended ampulla region, while naked, two or more cell embryos were present in the further parts of oviduct. These results indicate that in the rat apoptosis of cumulus granulosa cells starts shortly after ovulation in the peripheral region. Epithelial ampullary cells surrounding ovulated cumuli show a massive apoptosis.

Background: Data regarding the use of percutaneous coronary intervention with drug-eluting balloons (DEB) versus thin-strut drug-eluting stents (thin-DES) for treating DES in-stent restenosis in everyday clinical practice is scarce. Our goal was to evaluate the efficacy and safety profile of DEB versus thin-DES in DES in-stent restenosis. Methods: Consecutive patients with DES in-stent restenosis who underwent percutaneous coronary intervention between 2008 and 2019 entered the multicenter DEB-DRAGON Registry with a follow-up of 3 years. Patients who received DEB at the index procedure (n=557, 49.9%) were compared with those who received thin-DES (n=560, 50.1%). Results: Analysis of the unmatched cohort revealed lower rates of target lesion revascularization (9.1% versus 13.6%; hazard ratio [HR], 0.58 [95% CI, 0.41–0.83], P =0.003), target vessel revascularization (11.8% versus 16.7%; HR, 0.62 [95% CI, 0.45–0.84], P =0.003) and device-oriented composite end point, defined as a composite of cardiac death, target lesion revascularization, and target vessel myocardial infarction (12.7% versus 16.0%; HR, 0.69 [95% CI, 0.50–0.94], P =0.018) in the thin-DES group compared with the DEB group. The incidence of cardiac death, target vessel-myocardial infarction, and myocardial infarction were similar in both groups. However, after propensity score matching, there were no significant differences in target lesion revascularization (11.2% versus 11.2%; HR, 0.91 [95% CI, 0.55–1.51], P =0.707), target vessel revascularization (13.4% versus 14.2%; HR, 0.86 [95% CI, 0.55–1.36], P =0.523), and device-oriented composite end point (14.2% versus 14.2%; HR, 0.91 [95% CI, 0.58–1.42], P =0.667) between the thin-DES and DEB group, respectively. Conclusions: This analysis of a real-life registry revealed similar long-term outcomes of thin-DES and DEB in DES in-stent restenosis regarding target lesion revascularization, myocardial infarction, cardiac death, and device-oriented composite end point. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04415216.

No abstract

No abstract