Impact of Time to Coronary Angiography on Survival for NSTEMI

Non ST-elevation Myocardial Infarction Clinical Trial

Official title:

Impact of Time to Coronary Angiography on Survival for NSTEMI: an Observation Study Using a Nationwide Registry

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02693015
• Other study ID #: Time to coronary angiography
• Status: Completed
• Phase: N/A
• First received: February 23, 2016
• Last updated: February 25, 2016
• Start date: April 2004
• Est. completion date: March 2013

Study information

• Verified date: February 2016
• Source: University of Leeds
• Contact: n/a
• Is FDA regulated: No
• Health authority: United Kingdom: Research Ethics Committee
• Study type: Observational [Patient Registry]

Clinical Trial Summary

This study aims to investigate the extent to which the time to angiography impacts on survival in patients hospitalised with NSTEMI.

Description:

The use of an invasive strategy for the management of NSTEMI according to estimated risk of 6 month mortality is recommended by international guidelines. NSTEMI appropriate for coronary angiography (and percutaneous intervention) have better outcomes compare with NSTEMI who are medically managed. Whilst the national and international guidelines recommend that the timing of (in-hospital) coronary angiography (<24, 24-72, 72-96 and <96 hours) is based upon estimated clinical risk (using the GRACE risk score) there is scientific and clinical uncertainty as to the incremental benefit that more urgent invasive treatments strategies have over and above that of delayed strategies. Moreover, the investigators recent research has shown that in the UK, may NSTEMI (eligible) for coronary angiography fail to achieve care according to the recommended time thresholds, and this is associated with potentially avoidable premature death.

This study aims to investigate the extent to which the time to angiography impacts on survival in patients hospitalised with NSTEMI. It will characterise patients according to their estimated risk of death, their time to angiography, and associated outcomes. The investigators anticipate that this observational study will provide Level B evidence for the benefits of the timing of an invasive strategy according to the GRACE risk score. The investigators are aware that the NICE guidelines for the management of acute chest pain are to be updated in 2016.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 235986
• Est. completion date: March 2013
• Est. primary completion date: March 2013
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years to 100 Years

Eligibility

Inclusion Criteria:

• The target population will be all patients aged 18 to 100 years recorded within MINAP from 2004 to 2013 who have been hospitalised with NSTEMI and received coronary angiography.

Exclusion Criteria:

• Age below 18 or above 100 or age missing

• Diagnosis not NSTEMI

• Patients who did not receive coronary angiography - as this is the investigators explanatory variable

Study Design

Observational Model: Cohort, Time Perspective: Prospective

Related Conditions & MeSH terms

• Myocardial Infarction
• Non ST-elevation Myocardial Infarction

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
University of Leeds

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	All-cause mortality		30-day mortality since hospitalisation	No
Primary	Mortality		1-year mortality since hospitalisation	No