Cardiovascular Medication Use Before First Myocardial Infarction

Cardiovascular Medication Prescriptions Before First Myocardial Infarction in Patients With and Without Previously Diagnosed Atherosclerotic Disease: an Analysis of Linked Prospectively Collected Electronic Healthcare Records

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT01692795

Enrollment

17000

Registered

2012-09-25

Start date

2009-09-30

Completion date

2013-09-30

Last updated

2015-10-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Myocardial Infarction

Keywords

Myocardial infarction, Antiplatelets, Lipid lowering agents, ACE inhibitors, Angiotensin Receptor Blockers, Beta blockers, Blood pressure lowering drugs

Brief summary

Large randomised trials have shown that cardiovascular medications prescribed to patients at high cardiovascular risk are effective in reducing the incidence of cardiovascular events. Their use is recommended in the United Kingdom and international guidelines (e.g. the National Institute of Clinical Excellence). However, these medications do not prevent cardiovascular events in all patients and there is now a body of research investigating the effects of cardiovascular medications on outcomes in myocardial infarction (MI), including clinical presentation, infarct size and post-MI mortality. However, the independent effects of cardiovascular drugs on post-MI all cause mortality are unclear, and there are limitations to many of the published studies in terms of their cardiovascular drug exposure data. This project utilizes prospectively collected data on cardiovascular drug use, and links to MI data from hospital and mortality records.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

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 Myocardial Ischaemic National Audit Project (MINAP), Hospital Episode Statistics (HES) and Office for National Statistics (ONS) datasets. Patients must have at least one year of GPRD up to standard registration before the date of first myocardial infarction. Age over 18. First myocardial infarction occurring between 1st January 2003 and 31st December 2008, as recorded in the HES data or MINAP.

Exclusion criteria

Patients will be excluded if they do not fulfil one of the inclusion criteria.

Design outcomes

Primary

Measure	Time frame	Description
All cause mortality	Up to seven years	All cause mortality, using Office for National Statistics (ONS) mortality statistics
Re-infarction	One year after initial myocardial infarction	Reinfarction will be measured based on data from the General Practice Research Database (GPRD), Hospital Episode Statistics (HES), the Myocardial Ischaemia National Audit Project (MINAP) and Office for National Statistics (ONS) mortality data.

Secondary

Measure	Time frame	Description
Myocardial infarciton (MI) type	Measured at baseline	Diagnosed ST-elevation MI or non ST-elevation myocardial infarction

Other

Measure	Time frame	Description
Infarct size	Measured at baseline	Infarct size, as measured by levels of peak troponin in hospital, as recorded in the MINAP data source.

Countries

United Kingdom

Outcome results