Acute Myocardial Infarction Clinical Trial
Official title:
Compare the Patient Risk and Between-hospital Variation in Myocardial Infarction Mortality in the United Kingdom and Sweden
The study aims to investigate the differences in survival trajectories and hospital variability in myocardial infarction (MI) mortality rates in the UK and Sweden.
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.
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