Acute Coronary Syndrome, Age, Mortality, Troponin
Conditions
Brief summary
The National Institute for Health Research (NIHR) Cardiovascular Health Informatics Collaborative is an observational, multi-centre and longitudinal study of clinical data from collaborating hospitals. A dataset of the longitudinal record for patients who presented with a suspected acute coronary syndrome, characterised by the request of a troponin test, has been developed (NHIC-Troponin Study).
Detailed description
The NHIC Cardiovascular Project in the United Kingdom was established to enable the sharing and repurposing of routinely captured clinical data for re-use in research. Data sharing for this study has been enabled by establishing a data sharing agreement between each of the collaborating hospitals. The data sharing agreement allows data to be shared between National Health Service (NHS) hospitals in accordance with an anonymisation and de-identification profile approved by each information governance department, ensuring that patient identities are protected. Ethics approval for each dataset has been obtained which detailed the further de-identification steps to ensure that research datasets are fully anonymised. The cardiovascular theme clinical leads developed a standard target data model specification to capture the longitudinal record for patients who presented with a suspected acute coronary syndrome, characterised by the request of a troponin test (NHIC-Troponin Study). The data model was patient centric allowing for minor discrepancies between dataset areas such as missing discharges or test results returning outside of episodes of care. The model included 156 data points, grouped into demographics, cardiovascular risk factors, emergency department attendance and inpatient episodes, biochemistry, revascularisation and mortality. All patients were followed up on the NHS Spine Application, Summary Care Record until death or censoring on 1st April 2017. This dataset comprised all patients who had a troponin measured at each of the five major academic centres between 2010 (2008 for University College Hospital) and 2017. The investigators identified a total of 257948 patient records who underwent troponin testing during the study period. A Committee of Experts validates the protocol methodology and supervises the data management. A Steering Committee oversees study proposals including hypotheses, study design and statistical analyses including planned outcome measures.
Interventions
None listed
Sponsors
Imperial College London
Guy's and St Thomas' NHS Foundation Trust
King's College Hospital NHS Trust
Oxford University Hospitals NHS Trust
University College London Hospitals
University Hospital Southampton NHS Foundation Trust
University Hospitals, Leicester
University Hospitals Bristol and Weston NHS Foundation Trust
Manchester University NHS Foundation Trust
University Hospital Birmingham NHS Foundation Trust
The Leeds Teaching Hospitals NHS Trust
Blackpool Teaching Hospitals NHS Foundation Trust
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* All patients presenting to one of the collaborating hospitals.
Exclusion criteria
* Nil
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mortality, All-cause | Hospital admission to 3 years follow-up | Number of patients who died (from any cause) including in-hospital, short-term and long-term mortality |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Acute Revascularisation | 3 months follow-up | Acute revascularisation will be defined as having PCI or CABG in the time window between 48 hours before and 3 months after the first troponin measurement. This will account for patients who had revascularisation, in particular PCI, as an emergency prior to their first troponin blood test and to capture revascularisation, in particular CABG, performed as an outpatient following their index admission. |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Unselected Cohort of Patients Who Had a Troponin Measured A total of 257 948 patients who presented to hospital during the study period (2010-17) and had at least one troponin blood test measured. | 257,948 |
| Total | 257,948 |
Baseline characteristics
| Characteristic | Unselected Cohort of Patients Who Had a Troponin Measured |
|---|---|
| Age, Continuous | 65 years |
| Race/Ethnicity, Customized Black | 19925 Participants |
| Race/Ethnicity, Customized Missing | 60132 Participants |
| Race/Ethnicity, Customized Other | 23401 Participants |
| Race/Ethnicity, Customized South Asian | 7169 Participants |
| Race/Ethnicity, Customized White | 147321 Participants |
| Region of Enrollment United Kingdom | 257948 participants |
| Sex: Female, Male Female | 115230 Participants |
| Sex: Female, Male Male | 142718 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 55,850 / 257,948 |
| other Total, other adverse events | 0 / 0 |
| serious Total, serious adverse events | 0 / 0 |
Outcome results
Primary
Mortality, All-cause
Number of patients who died (from any cause) including in-hospital, short-term and long-term mortality
Time frame: Hospital admission to 3 years follow-up
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Unselected Cohort of Patients Who Had a Troponin Measured | Mortality, All-cause | 55850 Participants |
Secondary
Acute Revascularisation
Acute revascularisation will be defined as having PCI or CABG in the time window between 48 hours before and 3 months after the first troponin measurement. This will account for patients who had revascularisation, in particular PCI, as an emergency prior to their first troponin blood test and to capture revascularisation, in particular CABG, performed as an outpatient following their index admission.
Time frame: 3 months follow-up
Population: 134,517 accounts for the number of patients 'admitted' to hospital, who had a troponin measured.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Unselected Cohort of Patients Who Had a Troponin Measured | Acute Revascularisation | 17444 Participants |