MI Mortality Risk and Between-hospital Risk Variation in the United Kingdom and Sweden

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01359033
• Other study ID #: FP7-EIS-WP7-MINAP
• Status: Completed
• Phase: N/A
• First received: May 23, 2011
• Last updated: November 14, 2017
• Start date: March 2011
• Est. completion date: December 2014

Study information

• Verified date: February 2014
• Source: University College, London
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

The study aims to investigate the differences in survival trajectories and hospital variability in myocardial infarction (MI) mortality rates in the UK and Sweden.

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 510863
• Est. completion date: December 2014
• Est. primary completion date: December 2013
• Accepts healthy volunteers: No
• Gender: All
• Age group: 30 Years and older

Eligibility

Inclusion Criteria:

• Patients aged above 30 years old who had hospital admission for acute myocardial infarction.

• Admission period ranged from 1st January, 2004 to 31th December, 2008.

Exclusion Criteria:

• Patients with missing data in the admission time and/or primary outcomes.

Related Conditions & MeSH terms

• Acute Myocardial Infarction
• Infarction
• Myocardial Infarction

Locations

Country	Name	City	State
Sweden	Uppsala Clinial Research Center	Uppsala
United Kingdom	University College London	London

Sponsors (7)

Lead Sponsor

Collaborator

University College, London

MINAP: Myocardial Ischaemia National Audit Project, National Institute for Cardiovascular Outcomes Research, NICOR/MINAP, the United Kingdom, RIKS-HIA: Register of Information and Knowledge about Swedish Heart Intensive care Admissions, SWEDEHEART/RIKS-HIA, Sweden, SWEDEHEART: Swedish Web-System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies

Countries where clinical trial is conducted

Sweden,  United Kingdom, 

References & Publications (4)

Birkhead JS, Walker L, Pearson M, Weston C, Cunningham AD, Rickards AF; National Audit of Myocardial Infarction Project Steering Group. Improving care for patients with acute coronary syndromes: initial results from the National Audit of Myocardial Infarction Project (MINAP). Heart. 2004 Sep;90(9):1004-9. — View Citation

Birkhead JS, Weston C, Lowe D. Impact of specialty of admitting physician and type of hospital on care and outcome for myocardial infarction in England and Wales during 2004-5: observational study. BMJ. 2006 Jun 3;332(7553):1306-11. Epub 2006 May 16. — View Citation

Jernberg T, Attebring MF, Hambraeus K, Ivert T, James S, Jeppsson A, Lagerqvist B, Lindahl B, Stenestrand U, Wallentin L. The Swedish Web-system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies (SWEDEHEART). Heart. 2010 Oct;96(20):1617-21. doi: 10.1136/hrt.2010.198804. Epub 2010 Aug 27. — View Citation

Rosvall M, Ohlsson H, Hansen O, Chaix B, Merlo J. Auditing patient registration in the Swedish quality register for acute coronary syndrome. Scand J Public Health. 2010 Jul;38(5):533-40. doi: 10.1177/1403494810365109. Epub 2010 Apr 20. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	30-day mortality	all-cause mortality at 30-day following hospitalization for acute Myocardial Infarction	30-day
Secondary	1-year mortality	all-cause mortality at 1-year following hospitalization for acute Myocardial Infarction	1 year

External Links

•   Myocardial Ischaemia National Audit Project (MINAP)
•   The Register of Information and Knowledge about Swedish Heart Intensive care Admissions