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Investigating Variation in Hospital Acute Coronary Syndrome Outcomes

This study has been completed.
Information provided by (Responsible Party):
Oras Alabas, University of Leeds Identifier:
First received: March 23, 2013
Last updated: April 3, 2013
Last verified: April 2013
To investigate the causes of hospital variation in outcomes from acute coronary syndromes in England and develop recommendations for improving patient care.

Acute Myocardial Infarction

Study Type: Observational [Patient Registry]
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Target Follow-Up Duration: 12 Months
Official Title: Evaluation of the Methods and Management of Acute Coronary Events-4: Investigating Variation in Hospital Acute Coronary Syndrome Outcomes

Resource links provided by NLM:

Further study details as provided by Oras Alabas, University of Leeds:

Primary Outcome Measures:
  • Mortality [ Time Frame: 12 months ]

Secondary Outcome Measures:
  • Drug Adherence [ Time Frame: 12 month ]

Other Outcome Measures:
  • Health related quality of life assessement [ Time Frame: 12 month ]

Biospecimen Retention:   Samples With DNA
Blood, Urine

Enrollment: 5555
Study Start Date: March 2011
Study Completion Date: March 2013
Primary Completion Date: February 2013 (Final data collection date for primary outcome measure)
Acute myocardial infarction
Drug Adherence

Detailed Description:

Over the last few years the chance of dying from a heart attack in England and Wales has reduced dramatically. Even so, there remain huge differences in mortality between hospitals. For example, up to a third of patients with a heart attack who attend hospitals in England are more likely to die than would be expected. That is, the type of treatment and the risk of death depend upon where a patient lives and which hospital they attend. In part, the variation in death may be due to the services available at the hospital or to factors such as socioeconomic deprivation. It may also relate to other factors such as depression, cardiac rehabilitation, patient experience of hospital care and whether patients take their medication after discharge from hospital.

Notably, the challenges posed by poor drug adherence to secondary prevention medications are recognised by the World Health Organisation as the highest area of priority for improving individual health throughout the world. In addition, Patient Reported Outcome Measures (PROMs) are set to be the cornerstone of the evaluation of patient experiences of National Health Service quality of care.

Using statistical approaches that include measures of quality of life, we propose to examine data about heart attacks in England and investigate the 'postcode lottery of care'. Our aim, using regional data about heart attacks is to identify and measure the effects of hospital care. This research will identify hospital qualities that promote improved patient care. In doing so, best practice will be highlighted and healthcare policy changed so that all patients will have an equal chance of surviving a heart attack.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
A total of 5555 consented patients were recruited from acute Trusts in England.

Inclusion Criteria:

Age > 18 years, both sexes, acute admission to the acute Trust with suspected acute coronary syndrome (ACS).

Exclusion Criteria:

Patients at a terminal stage of any illness, and those in whom follow up would be inappropriate or impractical.

  Contacts and Locations
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Please refer to this study by its identifier: NCT01819103

Sponsors and Collaborators
University of Leeds
Principal Investigator: Chris P Gale, PhD University of Leeds
  More Information

Responsible Party: Oras Alabas, Dr, University of Leeds Identifier: NCT01819103     History of Changes
Other Study ID Numbers: 12/WM/0431
Study First Received: March 23, 2013
Last Updated: April 3, 2013

Keywords provided by Oras Alabas, University of Leeds:
Acute Myocardial Infarction
Drug Adherence
Drug Compliance
Health-related quality of life

Additional relevant MeSH terms:
Myocardial Infarction
Acute Coronary Syndrome
Pathologic Processes
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Vascular Diseases processed this record on August 18, 2017