Natural Ischaemic Preconditioning Before First Myocardial Infarction

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

16000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2009-09-30

Study Completion Date

2013-12-31

Brief Summary

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There is a sharp rise in the rate of coronary heart disease diagnoses and chest pain consultations in the 90 days before a first heart attack. There is some evidence that chest pain and angina symptoms in this period have a beneficial effect on heart attack outcomes in hospital and shortly after discharge. However, the available evidence is lacking in three key areas. First it is based on a retrospective patient report of symptoms after the heart attack has occurred; this means that patients are required to survive their heart attack and may make errors when reporting prior symptoms. Second, evidence for an effect on longer term outcomes, and coronary outcomes in particular (e.g. coronary death, further heart attacks) are unknown. Third, there is conflicting evidence that these effects might differ by age, in men and women, and according to treatment in hospital.

The investigators hope to address the limitations in the evidence by performing a large, prospective study of the occurrence, timing and effect of different types of symptoms and disease diagnoses occurring before heart attack.

The investigators hypothesise that prospectively collected, clinical measures of chest pain symptoms and cardiovascular diagnoses in primary care will have a beneficial effect on short term coronary mortality and may have a beneficial effect on longer term coronary outcomes.

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Detailed Description

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Conditions

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Myocardial Infarction Angina Pectoris Coronary Heart Disease Peripheral Arterial Disease Cerebrovascular Disease

Study Design

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Study Time Perspective

RETROSPECTIVE

Study Groups

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MI without ischaemic preconditioning

Myocardial infarction unheralded by any previous cardiovascular disease diagnosis and without symptoms of chest pain in the previous 90 days.

No interventions assigned to this group

MI with longstanding disease

Patients with myocardial infarction who have had diagnosed atherosclerotic disease for longer than 90 days preceding infarct.

No interventions assigned to this group

MI with only chest pain

Patients with chest pain in the 90 days preceding MI, but with no prior atherosclerotic disease diagnoses.

No interventions assigned to this group

MI with disease and chest pain

Myocardial infarction occurring with previously diagnosed atherosclerotic disease of longer than 90 days' duration, but with chest pain in 90 days preceding infarct.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patients in GPRD practices which are deemed "up to standard" by GPRD criteria will be included if their practice agreed to be linked to the MINAP, HES and ONS datasets.
* Patients must have at least one year of GPRD "up to standard" registration before the date of first MI.
* Age over 18.
* First myocardial infarction occurring between 1st January 2003 and 31st December 2008, as recorded in the Hospital Episode Statistics data or the Myocardial Ischaemia National Audit Project.

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No