Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
Survival After First Myocardial Infarction in Patients With and Without Chronic Obstructive Pulmonary Disease
An estimated three million people are affected by chronic obstructive pulmonary disease
(COPD) in the UK, giving it a prevalence of 1.5% of the population in 2007/08. COPD accounts
for approximately 30,000 deaths each year in the UK and is an important co-morbidity in
those dying from other smoking related diseases, most commonly ischaemic heart disease and
lung cancer. The National COPD audit showed a very high level of co-morbidity, the
association with cardiovascular disease being particularly strong with 51% of patients with
cardiovascular disease having been admitted for COPD within the preceding 24 months.
Patients with COPD are at increased risk of myocardial infarction compared to the general
population. Although this increase in cardiovascular risk exists, it is not clear is whether
survival after myocardial infarction is different in patients with and without COPD and what
factors contribute to this survival difference. Differences in survival may arise due to
differences in prescribing certain drugs such as beta-blockers, differences in prevalence of
risk factors (e.g. current smoking status) or increased COPD events such as exacerbations
which themselves are associated with increased mortality.
The investigators primary aim is to investigate whether survival after first myocardial
infarction is shorter in patients with COPD than those without COPD and to establish reasons
for these differences in survival.
Status | Completed |
Enrollment | 2100000 |
Est. completion date | December 2014 |
Est. primary completion date | December 2013 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
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 dataset. - Age over 18. Exclusion Criteria: - Patients will be excluded after experiencing their first MI. - Patients will be excluded if they do not fulfil one of the inclusion criteria. |
Observational Model: Cohort, Time Perspective: Retrospective
Country | Name | City | State |
---|---|---|---|
United Kingdom | London School of Hygiene and Tropical Medicine | London |
Lead Sponsor | Collaborator |
---|---|
London School of Hygiene and Tropical Medicine | British Medical Research Council, University College, London |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Death after a first ST elevation or non ST elevation MI | The primary outcome is death after a first ST elevation or non ST elevation MI. Death information will be based on data from one or more of the following: ONS death certificates; Hospital Episode Statistics; MINAP data; GPRD data. | Average time frame: patients in the GPRD are followed from registration until they experience the outcome, leave the practice, die, or 31st December 2009, whichever occurs first | No |
Secondary | Number of patients with and without COPD prescribed a beta blocker after a MI | Survival differences will be investigated with respect to a) differences in prevalence of risk factors (e.g. smoking) b) differences in management after myocardial infarction (e.g. uptake of cardiac rehabilitation, prescription of beta-blockers) and c) COPD related events (e.g. exacerbations). | Average time frame: patients in the GPRD are followed from registration until they experience the outcome, leave the practice, die, or 31st December 2009, whichever occurs first | No |
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