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July 21, 2010HeartOpen Access

The Myocardial Ischaemia National Audit Project (MINAP)

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Population

Consecutive unconsented patients with any acute coronary syndrome across 230 acute hospitals in England and…

Design

Cohort

Authors

EHEmily HerrettLSLiam SmeethCWClive Weston

Discussion

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Overview

Offers a national resource for ACS audit and research; extends registry data but leaves open causal inferences.

Key Points

  • The Myocardial Ischaemia National Audit Project (MINAP) evaluates the quality of care delivered to patients presenting with acute coronary syndrome across England and Wales and serves as a comprehensive registry for clinical research.
  • Audited consecutive, unconsented patients presenting with acute coronary syndromes—including STEMI, NSTEMI, and unstable angina—across all 230 acute hospitals in England and Wales from 2000 to the present (N=735,000).
  • Recorded 123 clinical, demographic, and therapeutic variables through hospital-level manual data entry, evaluated annually using a 20-record randomized validation sample.
  • Linked hospital audit records directly to the Office for National Statistics to monitor all-cause mortality.
  • Enrolled 735,000 patient records across 230 acute medical centers over ongoing surveillance since 2000.
  • Demonstrated data completeness exceeding 90% for 20 key clinical fields and surpassing 80% for all but four of the remaining variables during the 2008 audit.
  • Implemented continuous quality benchmarking and feedback loops delivered to hospitals, ambulance services, and regional cardiac networks.

Structured PICO

P
Population
Consecutive unconsented patients with any acute coronary syndrome (including non-ST-elevation myocardial infarction, ST-elevation myocardial infarction, and unstable angina) across 230 acute hospitals in England and Wales. Current number of records: 735,000.
I
Intervention
Feedback to hospitals, ambulance services and cardiac networks regarding benchmarking of performance against national standards and targets (quality of care interventions).
O
Outcome
All-cause mortality (obtained through linkage with Office for National Statistics)hard clinical

MINAP is a large-scale, national clinical audit and registry of acute coronary syndrome patients in England and Wales that facilitates quality improvement and academic research.

Limitations

  • No blood resource
  • No other linkages exist at present besides all-cause mortality

Cite This Study

Herrett et al. (2010) studied this question.

synapsesocial.com/papers/6a7cb32cb7ca9b673b7cd2cchttps://doi.org/10.1136/hrt.2009.192328
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Where are we today? Early results from MINAP, the national audit of myocardial infarction project2003 · 21 citations
  2. 2Improving care for patients with acute coronary syndromes: initial results from the National Audit of Myocardial Infarction Project (MINAP)2004 · 104 citations
  3. 3Predictors of in-hospital mortality for patients admitted with ST-elevation myocardial infarction: a real-world study using the Myocardial Infarction National Audit Project (MINAP) database2007 · 46 citations
  4. 4From quantity to quality: the central cardiac audit database project1999 · 33 citations
  5. 5Raised cardiac troponin T levels in patients without acute coronary syndrome2007 · 36 citations