The DISCO study-Does Interventionalists' Sex impact Coronary Outcomes?

Area of Science:

• Cardiology
• Interventional Cardiology
• Health Services Research

Background:

• Physician sex may influence patient outcomes in specific medical contexts.
• Limited data exist on the impact of operator sex on percutaneous coronary intervention (PCI) outcomes.
• PCI is a common cardiovascular procedure with significant implications for patient health.

Purpose of the Study:

• To investigate the association between operator sex and the appropriateness and outcomes of percutaneous coronary intervention (PCI).
• To determine if female interventional cardiologists have different PCI outcomes compared to male interventional cardiologists.
• To assess the impact of operator sex on procedural appropriateness and adherence to guideline-directed medical therapy.

Main Methods:

• Retrospective analysis of PCI procedures performed between January 2010 and December 2017 in 48 Michigan hospitals.
• Logistic regression models were used to adjust for baseline patient risk factors.
• Comparison of in-hospital outcomes (mortality, acute kidney injury, transfusion, major bleeding) and appropriateness rates between female and male operators.

Main Results:

• No significant differences in risk-adjusted in-hospital mortality, acute kidney injury, transfusion rates, or major bleeding were observed between patients treated by female versus male interventional cardiologists.
• Percutaneous coronary interventions performed by female interventional cardiologists were more frequently rated as appropriate (86.64% vs. 84.45%, p < 0.0001).
• Female interventional cardiologists demonstrated a higher likelihood of prescribing guideline-directed medical therapy.

Conclusions:

• Operator sex is not associated with significant differences in risk-adjusted in-hospital outcomes following percutaneous coronary intervention.
• Female interventional cardiologists perform PCI procedures with higher appropriateness ratings.
• Female interventional cardiologists are more likely to adhere to guideline-directed medical therapy recommendations, suggesting potential practice pattern differences.