Board-certified interventional cardiologist involvement during PCI was independently associated with lower in-hospital mortality (OR 0.89; 95% CI 0.86-0.92; P<0.001) and complications.
Observational (n=842,335)
Yes
Does board-certified interventional cardiologist involvement reduce in-hospital mortality and complications in patients undergoing percutaneous coronary intervention?
The involvement of board-certified interventional cardiologists during PCI is independently associated with lower in-hospital mortality and complications, highlighting the clinical value of formal certification and expertise.
Effect estimate: OR 0.89 (95% CI 0.86-0.92)
p-value: p=<0.001
BACKGROUND: Although percutaneous coronary intervention (PCI) has become safer due to advances in devices and procedural standardization, in-hospital outcomes may still vary depending on the involvement of certified interventional cardiologists (ICs). This study evaluated the association between board-certified IC involvement and in-hospital outcomes following PCI using a nationwide Japanese registry. METHODS AND RESULTS: We analyzed PCI cases between 2020 and 2023, classifying them according to the involvement (defined as acting as a primary operator or supervising assistant) of board-certified members of the Japanese Association of Cardiovascular Intervention and Therapeutics (BMCVIT). Among 842,335 PCI cases analyzed, 579,459 (68.8%) were performed with BMCVIT involvement. The frequency of BMCVIT involvement was higher for the treatment of patients with prior revascularization and complex lesions, but lower for patients admitted with acute coronary syndrome (ACS) or hemodynamic instability. After adjusting for baseline characteristics, BMCVIT involvement remained independently associated with lower in-hospital mortality (odds ratio OR 0.89; 95% confidence interval CI 0.86-0.92; P<0.001), composite in-hospital complications (OR 0.94; 95% CI 0.91-0.97, P<0.001), and access site bleeding (OR 0.88; 95% CI 0.80-0.97, P=0.012). Subgroup analyses revealed consistent mortality benefits across age, sex, dialysis status, lesion complexity, and institutional PCI volume, with stronger protection in patients without ACS or cardiogenic shock. CONCLUSIONS: BMCVIT involvement in PCI was independently associated with lower in-hospital mortality and complications, underscoring the quality gains of IC participation.
Ito et al. (Tue,) conducted a observational in Patients undergoing percutaneous coronary intervention (PCI) (n=842,335). Board-certified interventional cardiologist (BMCVIT) involvement vs. No board-certified interventional cardiologist involvement was evaluated on In-hospital mortality (OR 0.89, 95% CI 0.86-0.92, p=<0.001). Board-certified interventional cardiologist involvement during PCI was independently associated with lower in-hospital mortality (OR 0.89; 95% CI 0.86-0.92; P<0.001) and complications.