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日本介入心脏病学中的性别差异:女性操作者在经皮冠状动脉介入治疗中的结果

Gender Disparities in Japanese Interventional Cardiology: Outcomes of Female Operators in Percutaneous Coronary Interventions.

作者信息

Takahashi Saeko, Yamaji Kyohei, Kohsaka Shun, Hayashida Kyoko, Sato Junko, Tsukahara Reiko, Honye Junko, Amano Tetsuya, Kozuma Ken

机构信息

Department of Cardiology, Shonan Oiso Hospital, Oiso, Japan.

Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan.

出版信息

JACC Asia. 2024 Aug 20;4(9):674-683. doi: 10.1016/j.jacasi.2024.07.005. eCollection 2024 Sep.

Abstract

BACKGROUND

Gender disparity remains a significant global concern in interventional cardiology, and there is a lack of extensive research examining the outcomes of percutaneous coronary interventions (PCIs) performed by female interventionalists.

OBJECTIVES

The aim of this study was to examine the practice patterns and outcomes of PCIs conducted by female interventionalists in Japan.

METHODS

This retrospective observational study analyzed data from the Japanese Percutaneous Coronary Intervention registry between January 2019 and December 2021. The primary endpoint was in-hospital mortality and the secondary endpoint was the success rate of PCIs.

RESULTS

A total of 447 female operators (7.3% of all operators) performed 35,211 PCIs (5.3%) during the study period. Female doctors treated a higher percentage of patients with ST-segment elevation myocardial infarction compared with their male counterparts (20.2% vs 17.7%;  = 0.001), whereas male doctors were more likely to perform PCIs for left main disease (4.9% vs 5.9%;  < 0.001) and lesions treated with rotational atherectomy (3.5% vs 4.9%;  < 0.001). The success rate of PCIs was higher for female interventionalists (97.8% vs 97.2%;  < 0.001). After conducting a risk-adjusted analysis, we found no significant difference in in-hospital mortality (adjusted OR: 0.896; 95% CI: 0.78-1.03;  = 0.12), or procedural complications associated with the operator's gender.

CONCLUSIONS

Overall, female operators exhibited outcomes similar to their male counterparts in terms of adjusted procedural outcomes, and higher crude success rate in certain subgroups. These findings emphasize gender disparities and stress the need to increase gender diversity in interventional cardiology.

摘要

背景

性别差异仍是全球介入心脏病学领域的一个重大问题,目前缺乏对女性介入专家进行经皮冠状动脉介入治疗(PCI)结果的广泛研究。

目的

本研究旨在探讨日本女性介入专家进行PCI的实践模式和结果。

方法

这项回顾性观察研究分析了2019年1月至2021年12月期间日本经皮冠状动脉介入治疗注册中心的数据。主要终点是住院死亡率,次要终点是PCI成功率。

结果

在研究期间,共有447名女性操作者(占所有操作者的7.3%)进行了35211例PCI(占5.3%)。与男性医生相比,女性医生治疗ST段抬高型心肌梗死患者的比例更高(20.2%对17.7%;P = 0.001),而男性医生更有可能对左主干病变进行PCI(4.9%对5.9%;P < 0.001)以及对采用旋磨术治疗的病变进行PCI(3.5%对4.9%;P < 0.001)。女性介入专家的PCI成功率更高(97.8%对97.2%;P < 0.001)。在进行风险调整分析后,我们发现住院死亡率(调整后的OR:0.896;95%CI:0.78 - 1.03;P = 0.12)或与操作者性别相关的手术并发症没有显著差异。

结论

总体而言,在调整后的手术结果方面,女性操作者的表现与男性操作者相似,并且在某些亚组中的粗成功率更高。这些发现强调了性别差异,并强调了在介入心脏病学领域增加性别多样性的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a3e/11450856/296bf8c0f163/ga1.jpg

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