Sirolimus-eluting stent treatment at high-volume centers confers lower mortality at 6-month follow-up: results from the prospective multicenter German Cypher Registry

BACKGROUND: Studies continue to identify percutaneous coronary intervention procedural volume both at the institutional level and at the operator level as being strongly correlated with outcome. High-volume centers have been defined as those that perform >400 percutaneous coronary intervention procedures per year. The relationship between drug-eluting stent procedural volume and outcome is unknown. We investigated this relationship in the German Cypher Registry. METHODS AND RESULTS: The present analysis included 8201 patients treated with sirolimus-eluting stents between April 2002 and September 2005 in 51 centers. Centers that recruited >400 sirolimus-eluting stent patients in this time period were considered high-volume centers; those with 150 to 400 patients were considered intermediate-volume centers; and those with <150 patients were designated as low-volume centers. The primary end point was all death, myocardial infarction, and target-vessel revascularization at 6 months. This end point occurred in 11.3%, 12.1%, and 9.0% of patients in the low-, intermediate-, and high-volume center groups, respectively (P=0.0001). There was no difference between groups in the rate of target-vessel revascularization (P=0.2) or cerebrovascular accidents (P=0.5). The difference in death/myocardial infarction remained significant after adjustment for baseline factors (odds ratio 1.85, 95% confidence interval 1.31 to 2.59, P<0.001 for low-volume centers; odds ratio 1.69, 95% confidence interval 1.29 to 2.21, P<0.001 for intermediate-volume centers). Patient and lesion selection, procedural features, and postprocedural medications differed significantly between groups. CONCLUSIONS: The volume of sirolimus-eluting stent procedures performed on an institutional level was inversely related to death and myocardial infarction but not to target-vessel revascularization at 6-month follow-up. Safety issues are better considered in high-volume centers. These findings have important public health policy implications.

The role of Central Europe in the German economy. The political consequences. OSW Report June 2016

Recent publications allow us to conclude that the economic relations between Germany and Central Europe have come to the ‘end of history’, and nothing new will happen. However, a deeper analysis of these relationships reveals interesting new trends. Since joining the European Union the states of Central Europe have not settled for maintaining the average level of economic development, but have continued to narrow the distance between them and Western Europe, something which the global financial crisis did not prevent. Their improved economic situation also affected their relations with Germany. The latest results from the Visegrád Group states show them to be Germany’s most important trading partner, and their balance of trade in goods is in a state of equilibrium, while many euro area countries have recorded high trade deficits with Germany. The aim of this report is to display the trends in trade and investment between Germany and Central Europe, based on the example of the Visegrád Group. The author will also attempt to answer the question of whether the advancing economic cooperation between Germany and the V4 countries will lead to the further modernisation of those countries’ economies, or whether it will run the risk of leaving them in the ‘middle income trap’.

Phonetics of the New High German language.

Mode of access: Internet.

History of the German people at the close of the middle ages,

"Art and popular literature to the beginning of the thirty years' war": vol. X-XII.

Die mittelniederdeutsche Version des Bienenbuches von Thomas von Chantimpré. Das erste Buch. [Middle Low German translation of Bonum Universale de Apibus by Thomas Cantipratenisis.

Mode of access: Internet.

A short German grammar for high schools and colleges /

Includes index.

Historic background and annals of the Swiss and German pioneer settlers of southeastern Pennsylvania, and of their remote ancestors, from the middle of the dark ages, down to the time of the revolutionary war; an authentic history, from original sources ... with particular reference to the German-Swiss Mennonites or Anabaptists, the Amish and other nonresistant sects.

Mode of access: Internet.

Elements of the comparative grammar of the Indo-Germanie languages. A concise exposition of the history of Sanskrit, Old Iranian ... Old Armenian. Old Greek, Latin, Umbrian-Samnitic. Old Irish. Gothic. Old High German, Lithuanian and Old Bulgarian.

Vols. II-[V] have title: A comparative grammar of the Indo-Germanic languages. Other variations in title.

Handbook of German literature : containing Schiller's Maid of Orleans, Goethe's Iphigenia, Tieck's Puss in Boots, Xenien by Goethe and Schiller, with critical introductions and explanatory notes ; to which is added an appendix of specimens of German prose from the middle of the sixteenth to the middle of the nineteenth centuries /

Mode of access: Internet.

The high school German grammar and reader : with appendices, exercises in composition, and vocabularies /

Includes index.

Handbook of German literature : containing : Schiller's Maid of Orleans, Goethe's Iphigenia in Tauris, Tieck's Puss in boots, The Xenia by Goethe and Schiller : with critical introductions and explanatory notes : to which is added an appendix of specimens of German prose from the middle of the sixteenth to the middle of the nineteenth centuries /

Mode of access: Internet.

The historic geographical atlas of the middle and modern ages. : A series of maps and plans, chronologically arranged, delineating the migrations of the German and Asiatic nation, and the rise and fall of all the states, kingdoms, and empires, founded by them in Europe, western Asia, northern Africa, and America, from the fall of the western Roman empire, to the abdication of Napoleon. With special maps illustrative of English history. /

Mode of access: Internet.