Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)

Birkhead, J S; M, C F; Chen, R; Weston, Clive

doi:10.1136/hrt.2008.164426

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Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)

J S Birkhead, C F M Weston, R Chen, Clive Weston

Heart, Volume: 95, Issue: 19, Pages: 1593 - 1599

Swansea University Author: Clive Weston

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DOI (Published version): 10.1136/hrt.2008.164426

Abstract

Using an observational study design we investigated determinants of, and outcomes from, coronary angiography and intervention in 13,489 admissions to 44 British hospitals with non-ST-segment elevation myocardial infarction (NSTEMI) between July 2005 to December 2006.Significantly lower rates of angi...

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Published in:	Heart
ISSN:	1355-6037
Published:	2009
Online Access:	Check full text
URI:	https://cronfa.swan.ac.uk/Record/cronfa10196
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first_indexed	2013-07-23T12:02:58Z
last_indexed	2018-02-09T04:38:48Z
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spelling	2013-11-08T11:20:46.2082504 v2 10196 2012-03-21 Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP) df85e4e0e139d0f46eb683174eba98a9 0000-0002-8995-8199 Clive Weston Clive Weston true false 2012-03-21 PMSC Using an observational study design we investigated determinants of, and outcomes from, coronary angiography and intervention in 13,489 admissions to 44 British hospitals with non-ST-segment elevation myocardial infarction (NSTEMI) between July 2005 to December 2006.Significantly lower rates of angiography were seen for women, the elderly, the most deprived and those having cardiac, and most non-cardiac, comorbidities. Performance of angiography, compared with no angiography, was not associated with lower rate of readmission (multiple adjusted hazard ratio (HR) = 0.96, 95% CI 0.74 to 1.24) unless accompanied by coronary intervention (HR = 0.73, 95% CI 0.56 to 0.95). Angiography was associated with reduction in 180-day mortality for survivors of hospitalisation (HR = 0.59, 95% CI 0.49 to 0.72); with greater reduction when followed by an intervention (HR = 0.34, 95% CI 0.28 to 0.42). This mortality benefit after intervention was seen both in women (HR = 0.42, 95% CI 0.29 to 0.60) and men (HR = 0.31, 95% CI 0.24 to 0.41), and across age groups: <65 years (HR = 0.25, 95% CI 0.14 to 0.44), 65-79 years (HR = 0.29, 95% CI 0.22 to 0.39) and > or =80 years (HR = 0.52, 95% CI 0.37 to 0.74). Mortality benefit was not significantly attenuated by the presence of comorbidities.Performance of angiography and coronary intervention after NSTEMI was associated with mortality benefit that persisted in the presence of both cardiac and non-cardiac comorbidities. Mortality benefit was seen across age groups and was similar for both sexes. Journal Article Heart 95 19 1593 1599 1355-6037 Acute coronary syndrome; 31 12 2009 2009-12-31 10.1136/hrt.2008.164426 COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University 2013-11-08T11:20:46.2082504 2012-03-21T16:17:18.0000000 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine J S Birkhead 1 C F M Weston 2 R Chen 3 Clive Weston 0000-0002-8995-8199 4
title	Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
spellingShingle	Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP) Clive Weston
title_short	Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
title_full	Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
title_fullStr	Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
title_full_unstemmed	Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
title_sort	Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)
author_id_str_mv	df85e4e0e139d0f46eb683174eba98a9
author_id_fullname_str_mv	df85e4e0e139d0f46eb683174eba98a9_***_Clive Weston
author	Clive Weston
author2	J S Birkhead C F M Weston R Chen Clive Weston
format	Journal article
container_title	Heart
container_volume	95
container_issue	19
container_start_page	1593
publishDate	2009
institution	Swansea University
issn	1355-6037
doi_str_mv	10.1136/hrt.2008.164426
college_str	Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id	facultyofmedicinehealthandlifesciences
hierarchy_top_title	Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id	facultyofmedicinehealthandlifesciences
hierarchy_parent_title	Faculty of Medicine, Health and Life Sciences
department_str	Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str	0
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description	Using an observational study design we investigated determinants of, and outcomes from, coronary angiography and intervention in 13,489 admissions to 44 British hospitals with non-ST-segment elevation myocardial infarction (NSTEMI) between July 2005 to December 2006.Significantly lower rates of angiography were seen for women, the elderly, the most deprived and those having cardiac, and most non-cardiac, comorbidities. Performance of angiography, compared with no angiography, was not associated with lower rate of readmission (multiple adjusted hazard ratio (HR) = 0.96, 95% CI 0.74 to 1.24) unless accompanied by coronary intervention (HR = 0.73, 95% CI 0.56 to 0.95). Angiography was associated with reduction in 180-day mortality for survivors of hospitalisation (HR = 0.59, 95% CI 0.49 to 0.72); with greater reduction when followed by an intervention (HR = 0.34, 95% CI 0.28 to 0.42). This mortality benefit after intervention was seen both in women (HR = 0.42, 95% CI 0.29 to 0.60) and men (HR = 0.31, 95% CI 0.24 to 0.41), and across age groups: <65 years (HR = 0.25, 95% CI 0.14 to 0.44), 65-79 years (HR = 0.29, 95% CI 0.22 to 0.39) and > or =80 years (HR = 0.52, 95% CI 0.37 to 0.74). Mortality benefit was not significantly attenuated by the presence of comorbidities.Performance of angiography and coronary intervention after NSTEMI was associated with mortality benefit that persisted in the presence of both cardiac and non-cardiac comorbidities. Mortality benefit was seen across age groups and was similar for both sexes.
published_date	2009-12-31T03:11:34Z
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Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the Myocardial Ischaemia National Audit Project (MINAP)

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