Practice Patterns and Outcomes of Women Interventional Cardiologists in Treatment of STEMI

BACKGROUND: Women are known to have worse outcomes than men in acute myocardial infarction. There is increasing evidence that gender discordance between patients and physicians may be a contributing factor to poor outcomes. Whether the gender of the interventional cardiologist influences outcomes in STEMI and whether this varies based on patient gender is unknown. We sought to ascertain whether the gender of the interventional cardiologist has an association with patient outcome. METHODS: The NCDR CathPCI registry was queried for cases coded as "Primary PCI for STEMI" between April 2018 and March 2025. These cases were stratified by both patient and cardiologist gender. Logistic regression models were performed and sequentially adjusted for patient and hospital characteristics. Outcomes of interest were door to balloon time (DTB), in-hospital mortality, documented non-system reasons for delay, and door-to-door time (DTD) among transferred- in patients. RESULTS: Among 834,465 primary PCI procedures for STEMI, only 44,335 (5.3%) were performed by female interventionalists. Male interventionalists were more likely to meet DTB standards. Female interventionalists were more likely to document non-system reasons for delay. There was no evidence of influence of operator gender on the outcomes of patients, when stratified by patient gender. CONCLUSIONS: Female interventionalists performed a small proportion of primary STEMI PCI procedures. Although female interventionalists had lower adjusted odds of achieving DTB < 90 minutes, interventionalist gender was not associated with adjusted in-hospital mortality. These findings were consistent across male and female patient subgroups and highlight persistent differences in selected care-process measures without a corresponding detectable difference in mortality.