title: Women in interventional cardiology: Update in percutaneous coronary intervention practice patterns and outcomes of female operators from the National Cardiovascular Data Registry®.
abstract: OBJECTIVE
  To examine the practice patterns and outcomes of percutaneous coronary intervention (PCI) procedures performed by female interventional cardiologists in the United States (U.S.).
  
  
  BACKGROUND
  Little is known about the prevalence, volume, case mix, and outcomes of PCI procedures performed by female interventional cardiologists.
  
  
  METHODS
  Using data from the National Cardiovascular Data Registry(®) , we performed a retrospective study of 2,465,685 PCI procedures performed at 1,431 U.S. hospitals between July 1, 2009 and June 30, 2013. Interventionalist sex was ascertained from the National Provider Identifier number of each operator.
  
  
  RESULTS
  Women accounted for only 4% (412/9,179) of interventional cardiologists in the U.S., and performed 3% (n = 70,009) of all PCI procedures during the time period studied. Forty-one percent of female interventionalists operated at an institution with no other female operators. Female interventionalists performed a median of 48 PCI procedures per year (interquartile range: 22-87). Of the cases performed by female interventionalists, 77% were performed on patients with acute coronary syndrome, 3% on patients with cardiogenic shock, and 16% on call. In-hospital mortality was low (1.8%), and was not significantly different between female operators with high (≥50 cases/year) versus low (1.95% vs. 1.75%, unadjusted P = 0.12, adjusted OR: 1.03, 95% CI: 0.84-1.27) annual procedure volume.
  
  
  CONCLUSIONS
  Female interventional cardiologists remain uncommon in contemporary U.S. practice. Performing only a very small proportion of PCI cases, female interventionalists are often low-volume operators, yet no significant differences in patient mortality were observed in low- versus high-volume operators.
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
authors.forename: Tracy Y
authors.initials: TY
authors.lastname: Wang
authors.affiliation: Detroit Medical Center Cardiovascular Institute, Detroit, Michigan.
authors.forename: Cindy
authors.initials: C
authors.lastname: Grines
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ortega
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.
authors.forename: David
authors.initials: D
authors.lastname: Dai
authors.affiliation: Boston Medical Center, Boston, Massachusetts.
authors.forename: Alice K
authors.initials: AK
authors.lastname: Jacobs
authors.affiliation: Geisinger Medical Center, Danville, Pennsylvania.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Skelding
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Laura
authors.initials: L
authors.lastname: Mauri
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
mesh_terms: D039602:After-Hours Care / Q000639:trends; D000072096:Cardiologists / Q000639:trends*; D005260:Female; D006331:Heart Diseases / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008913:Minority Groups; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000401:mortality / Q000639:trends*; D010822:Physicians, Women / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D017064:Process Assessment, Health Care / Q000639:trends*; D012042:Registries; D012189:Retrospective Studies; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
keywords: female interventionalists; patterns of practice