The outcomes of PCI procedures are not affected by whether a physician holds a certification in interventional cardiology, researchers reported in Circulation.
“Although [interventional cardiology] certification has been in place for 16 years, the association between [interventional cardiology] certification and the outcomes of patients undergoing PCI has not been evaluated,” the researchers wrote.
Paul N. Fiorilli, MD, from the section of cardiovascular medicine, department of internal medicine, Hospital of the University of Pennsylvania, and colleagues examined the outcomes of 510,708 PCI procedures performed by 5,175 physicians in 2010 using data collected from the American Board of Internal Medicine (ABIM). Physicians were excluded if they could not be linked to data from the ABIM, had missing certification data in the ABIM database or performed fewer than 10 PCI procedures in 2010.
Case mix and unadjusted outcomes were similar among physicians certified in interventional cardiology and physicians who were not certified. Adjusted risks of in-hospital mortality (OR = 1.1; 95% CI, 1.02-1.19) and emergency CABG (OR = 1.32; 95% CI, 1.12-1.56) were higher in the uncertified group, but the risks for bleeding, vascular complications and the composite endpoint of any outcome (death, bleeding, vascular complications and emergency revascularization) were not significantly different between groups. Among patients discharged on aspirin, thienopyridines and statins after PCI, those treated by certified physicians were more likely to be discharged on each medication.
“We found that the care and outcomes of patients undergoing PCI procedures were generally similar regardless of the [interventional cardiology] certification status of the performing physician. … The outcomes of patients undergoing PCI were excellent and varied modestly depending on the certification status of the performing physician. Our findings suggest there is an opportunity to enhance the value of subspecialty certification,” the researchers wrote. – by Julia Ernst, MS
Disclosure: Three researchers report current or previous employment by ABIM. See the full study for a list of the other authors’ relevant financial disclosures.