Coronary disease & ACSCohort study
Case Volumes and Outcomes Among Early-Career Interventional Cardiologists in the United States
- Retrospective cohort study
- registry-based
Authors' conclusion
Early-career operators are caring for patients with more acute presentations and higher predicted risk of mortality and bleeding compared with more experienced colleagues, with modestly worse outcomes.
Study context
- Population
- Patients undergoing Percutaneous Coronary Intervention (PCI) in the US (NCDR CathPCI Registry), April 2018–June 20221,011 operators changed status
- Participants
- 1,451 vs 6,251
- Exposure
- Early-career vs non-early-career interventional cardiologists
- Early careern = 1,451
- Non-early careern = 6,251reference
Main finding
As reported in the abstract
Mortality and bleeding (adjusted)
Early career vs Non-early careerOdds ratio (95% CI)P value
mortality
1.08(1.05–1.17)
P < 0.0001bleeding
1.08(1.05–1.12)
P < 0.0001Observational data: associations, not effects.
Further findings
| Outcome | Early career | Non-early career |
|---|---|---|
| Patients treated | 514,540 events | 2,296,576 events |
| Annual case volume per operator | median 59 (IQR 31–97) | median 57 (IQR 28–100) |
| Predicted mortality risk | median 2.0% (IQR 1.5%–2.7%) | median 1.8% (IQR 1.2%–2.4%) |
| Predicted bleeding risk | median 4.9% (IQR 4.2%–5.7%) | median 4.4% (IQR 3.7%–5.3%) |
STEMI and urgent PCI indications
- More likely treated by early-career operators
- P < 0.001
Original publication
Case Volumes and Outcomes Among Early-Career Interventional Cardiologists in the United States. J Am Coll Cardiol. Published 21 May 2024. doi:10.1016/j.jacc.2024.03.395
Summarised from the published abstract; every number is checked against it