RT Journal Article SR Electronic T1 Association between operator volume and mortality in primary percutaneous coronary intervention JF Open Heart JO Open Heart FD British Cardiovascular Society SP e002072 DO 10.1136/openhrt-2022-002072 VO 9 IS 2 A1 Arvindra Krishnamurthy A1 Claire M Keeble A1 Michelle Anderson A1 Natalie Burton-Wood A1 Kathryn Somers A1 Charlotte Harland A1 Paul D Baxter A1 Jim M McLenachan A1 Jonathan M Blaxill A1 Daniel J Blackman A1 Christopher J Malkin A1 Stephen B Wheatcroft A1 John P Greenwood YR 2022 UL http://openheart.bmj.com/content/9/2/e002072.abstract AB Background There is a paucity of real-world data assessing the association of operator volumes and mortality specific to primary percutaneous coronary intervention (PPCI).Methods Demographic, clinical and outcome data for all patients undergoing PPCI in Leeds General Infirmary, UK, between 1 January 2009 and 31 December 2011, and 1 January 2013 and 31 December 2013, were obtained prospectively. Operator volumes were analysed according to annual operator PPCI volume (low volume: 1–54 PPCI per year; intermediate volume: 55–109 PPCI per year; high volume: ≥110 PPCI per year). Cox proportional hazards regression analyses were undertaken to investigate 30-day and 12-month all-cause mortality, adjusting for confounding factors.Results During this period, 4056 patients underwent PPCI, 3703 (91.3%) of whom were followed up for a minimum of 12 months. PPCI by low-volume operators was associated with significantly higher adjusted 30-day mortality (HR 1.48 (95% CI 1.05 to 2.08); p=0.02) compared with PPCI performed by high-volume operators, with no significant difference in adjusted 12-month mortality (HR 1.26 (95% CI 0.96 to 1.65); p=0.09). Comparisons between low-volume and intermediate-volume operators, and between intermediate and high-volume operators, showed no significant differences in 30-day and 12-month mortality.Conclusions Low operator volume is independently associated with higher probability of 30-day mortality compared with high operator volume, suggesting a volume–outcome relationship in PPCI at a threshold higher than current recommendations.Data are available on reasonable request.