MI Mortality Risk and Between-hospital Risk Variation in the United Kingdom and Sweden

NCT ID: NCT01359033

Last Updated: 2017-11-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

510863 participants

Study Classification

OBSERVATIONAL

Study Start Date

2011-03-31

Study Completion Date

2014-12-31

Brief Summary

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The study aims to investigate the differences in survival trajectories and hospital variability in myocardial infarction (MI) mortality rates in the UK and Sweden.

Detailed Description

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Limited evidence is available in comparing hospital level care and reference mortality risks between countries, due to the scarce availability of nationwide coronary heart disease data. The demographics and medical expenditure percentage are comparable in the United Kingdom and Sweden; however, the in-hospital case-fatality rates within 30 days after admission for acute myocardial infarction was greater in the UK than Sweden (6.3% versus 2.9%)(OECD, 2009). To investigate the discrepancy, the current study aims to compare the mortality risk differences and associated explanatory factors between the two countries. Results of the study can contribute to myocardial infarction care implementation in the UK and Sweden.

The UK Myocardial Ischaemia National Audit Project (MINAP)and Register of Information and Knowledge about Swedish Heart Intensive care Admissions (RIKS-HIA) are few quality national registries currently available for acute coronary syndrome. Using data from the MINAP and RIKS-HIA, we propose to investigate (1)the survival trajectories for a reference patient with myocardial infarction and (2) hospital variability in myocardial infarction mortality rate in the UK and Sweden, adjusted for important patient-level and hospital-level covariates.

Conditions

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Acute Myocardial Infarction

Keywords

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Myocardial Infarction UK Sweden National audit registry MINAP RIKS-HIA

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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MINAP cohort

The Myocardial Ischaemia National Audit Project (MINAP) was established in 1999, in response to the national service framework (NSF) for coronary heart disease, to examine the quality of management of heart attacks (myocardial infarction) in hospitals in England and Wales.

No interventions assigned to this group

RIKS-HIA cohort

The Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA) has been established to record clinical and treatment information for all patients admitted to the coronary care units in Sweden from 1995.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patients aged above 30 years old who had hospital admission for acute myocardial infarction.
* Admission period ranged from 1st January, 2004 to 31th December, 2008.

Exclusion Criteria

* Patients with missing data in the admission time and/or primary outcomes.
Minimum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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NICOR/MINAP, the United Kingdom

UNKNOWN

Sponsor Role collaborator

National Institute for Cardiovascular Outcomes Research

OTHER

Sponsor Role collaborator

MINAP: Myocardial Ischaemia National Audit Project

UNKNOWN

Sponsor Role collaborator

SWEDEHEART/RIKS-HIA, Sweden

UNKNOWN

Sponsor Role collaborator

SWEDEHEART: Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies

UNKNOWN

Sponsor Role collaborator

RIKS-HIA: Register of Information and Knowledge about Swedish Heart Intensive care Admissions

UNKNOWN

Sponsor Role collaborator

University College, London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sheng-Chia Chung, Ph.D

Role: PRINCIPAL_INVESTIGATOR

University College, London

Locations

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Uppsala Clinial Research Center

Uppsala, , Sweden

Site Status

University College London

London, , United Kingdom

Site Status

Countries

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Sweden United Kingdom

References

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Rosvall M, Ohlsson H, Hansen O, Chaix B, Merlo J. Auditing patient registration in the Swedish quality register for acute coronary syndrome. Scand J Public Health. 2010 Jul;38(5):533-40. doi: 10.1177/1403494810365109. Epub 2010 Apr 20.

Reference Type BACKGROUND
PMID: 20406796 (View on PubMed)

Jernberg T, Attebring MF, Hambraeus K, Ivert T, James S, Jeppsson A, Lagerqvist B, Lindahl B, Stenestrand U, Wallentin L. The Swedish Web-system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies (SWEDEHEART). Heart. 2010 Oct;96(20):1617-21. doi: 10.1136/hrt.2010.198804. Epub 2010 Aug 27.

Reference Type BACKGROUND
PMID: 20801780 (View on PubMed)

Birkhead JS, Walker L, Pearson M, Weston C, Cunningham AD, Rickards AF; National Audit of Myocardial Infarction Project Steering Group. Improving care for patients with acute coronary syndromes: initial results from the National Audit of Myocardial Infarction Project (MINAP). Heart. 2004 Sep;90(9):1004-9. doi: 10.1136/hrt.2004.034470.

Reference Type BACKGROUND
PMID: 15310686 (View on PubMed)

Birkhead JS, Weston C, Lowe D. Impact of specialty of admitting physician and type of hospital on care and outcome for myocardial infarction in England and Wales during 2004-5: observational study. BMJ. 2006 Jun 3;332(7553):1306-11. doi: 10.1136/bmj.38849.440914.AE. Epub 2006 May 16.

Reference Type BACKGROUND
PMID: 16705004 (View on PubMed)

Chung SC, Sundstrom J, Gale CP, James S, Deanfield J, Wallentin L, Timmis A, Jernberg T, Hemingway H; Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies/Register of Information and Knowledge about Swedish Heart Intensive care Admissions; National Institute for Cardiovascular Outcomes Research/Myocardial Ischaemia National Audit Project; CAardiovascular Disease Research Using Linked Bespoke Studies and Electronic Health Records. Comparison of hospital variation in acute myocardial infarction care and outcome between Sweden and United Kingdom: population based cohort study using nationwide clinical registries. BMJ. 2015 Aug 7;351:h3913. doi: 10.1136/bmj.h3913.

Reference Type DERIVED
PMID: 26254445 (View on PubMed)

Chung SC, Gedeborg R, Nicholas O, James S, Jeppsson A, Wolfe C, Heuschmann P, Wallentin L, Deanfield J, Timmis A, Jernberg T, Hemingway H. Acute myocardial infarction: a comparison of short-term survival in national outcome registries in Sweden and the UK. Lancet. 2014 Apr 12;383(9925):1305-1312. doi: 10.1016/S0140-6736(13)62070-X. Epub 2014 Jan 23.

Reference Type DERIVED
PMID: 24461715 (View on PubMed)

Related Links

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http://www.hqip.org.uk/myocardial-ischaemia-national-audit-project-minap/

Myocardial Ischaemia National Audit Project (MINAP)

http://www.ucr.uu.se/rikshia/

The Register of Information and Knowledge about Swedish Heart Intensive care Admissions

Other Identifiers

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FP7-EIS-WP7-MINAP

Identifier Type: -

Identifier Source: org_study_id