eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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vol. 19
Original paper

Operator-patient sex discordance and periprocedural outcomes of percutaneous coronary intervention (from the ORPKI Polish National Registry)

Artur Dziewierz
1, 2
Birgit Vogel
Barbara Zdzierak
Martyna Kuleta
Krzysztof P. Malinowski
5, 6
Tomasz Rakowski
1, 2
Aleksandra Piotrowska
Roxana Mehran
Zbigniew Siudak

2nd Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
Collegium Medicum, Jan Kochanowski University, Kielce, Poland
Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Krakow, Poland
Digital Medicine & Robotics Center, Jagiellonian University Medical College, Krakow, Poland
Adv Interv Cardiol 2023; 19, 2 (72): 113–118
Online publish date: 2023/06/30
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A recent study suggested that sex discordance between surgeons and patients negatively affects the outcomes of patients undergoing common surgical procedures.

We sought to assess whether such an impact exists for periprocedural outcomes of percutaneous coronary intervention (PCI).

Material and methods:
From 2014 to 2020, data on 581,744 patients undergoing single-stage coronary angiography and PCI from 154 centers were collected. Patients were divided into four groups based on the patient and operator sex. Operator-patient sex discordance was defined as the procedure done by a male operator on a female patient or by a female operator on a male patient.

Of 581,744 patients treated by 34 female and 782 male operators, 194,691 patients were sex discordant with their operator (female operator with male patient 12,479; male operator with female patient 182,212) while 387,053 were sex concordant (female operator with female patient 6,068; male operator with male patient 380,985). Among female patients, no difference in the risk of periprocedural complications, including death (0.65% vs. 0.82%; p = 0.10), between patients discordant versus concordant with operators was observed. Among male patients the risk of death (0.55% vs. 0.43%; p = 0.037) and bleeding at the puncture site (0.13% vs. 0.08%; p = 0.046) was higher in patients discordant with operators. However, the differences were no longer significant after adjustment for covariates.

No detrimental effect of operator-patient sex discordance on periprocedural outcomes was confirmed in all-comer patients undergoing PCI. Some of the observed differences in outcomes were primarily related to the differences in baseline risk profile.


sex, gender, doctor-patient interaction, patient-physician relationship, complications

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