Skip to main content
Journal cover image

International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries

Publication ,  Journal Article
McNamara, RL; Chung, SC; Jernberg, T; Holmes, D; Roe, M; Timmis, A; James, S; Deanfield, J; Fonarow, GC; Peterson, ED; Jeppsson, A; Hemingway, H
Published in: International Journal of Cardiology
August 1, 2014

Objectives To compare management of patients with acute non-ST segment elevation myocardial infarction (NSTEMI) in three developed countries with national ongoing registries. Background Results from clinical trials suggest significant variation in care across the world. However, international comparisons in "real world" registries are limited. Methods We compared the use of in-hospital procedures and discharge medications for patients admitted with NSTEMI from 2007 to 2010 using the unselective MINAP/NICOR [England and Wales (UK); n = 137,009], the unselective SWEDEHEART/RIKS-HIA (Sweden; n = 45,069), and the selective ACTION Registry-GWTG/NCDR [United States (US); n = 147,438] clinical registries. Results Patients enrolled among the three registries were generally similar except those in the US who were younger but had higher rates of smoking, diabetes, hypertension, prior heart failure, and prior MI than in Sweden or in UK. Angiography and percutaneous coronary intervention (PCI) were performed more often in the US (76% and 44%) and Sweden (65% and 42%) relative to the UK (32% and 22%). Discharge betablockers were also prescribed more often in the US (89%) and Sweden (89%) than in the UK (76%). In contrast, discharge statins, angiotensin converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB), and dual antiplatelet agents (among those not receiving PCI) were higher in the UK (92%, 79%, and 71%) than in the US (85%, 65%, 41%) and Sweden (81%, 69%, and 49%). Conclusions The care for patients with NSTEMI differed substantially among the three countries. These differences in care among countries provide an opportunity for future comparative effectiveness research as well as identify opportunities for global quality improvement. © 2014 The Authors. Published by Elsevier Ireland Ltd.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

International Journal of Cardiology

DOI

EISSN

1874-1754

ISSN

0167-5273

Publication Date

August 1, 2014

Volume

175

Issue

2

Start / End Page

240 / 247

Related Subject Headings

  • Cardiovascular System & Hematology
  • 3201 Cardiovascular medicine and haematology
  • 1117 Public Health and Health Services
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
McNamara, R. L., Chung, S. C., Jernberg, T., Holmes, D., Roe, M., Timmis, A., … Hemingway, H. (2014). International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries. International Journal of Cardiology, 175(2), 240–247. https://doi.org/10.1016/j.ijcard.2014.04.270
McNamara, R. L., S. C. Chung, T. Jernberg, D. Holmes, M. Roe, A. Timmis, S. James, et al. “International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries.” International Journal of Cardiology 175, no. 2 (August 1, 2014): 240–47. https://doi.org/10.1016/j.ijcard.2014.04.270.
McNamara RL, Chung SC, Jernberg T, Holmes D, Roe M, Timmis A, James S, Deanfield J, Fonarow GC, Peterson ED, Jeppsson A, Hemingway H. International comparisons of the management of patients with non-ST segment elevation acute myocardial infarction in the United Kingdom, Sweden, and the United States: The MINAP/NICOR, SWEDEHEART/RIKS-HIA, and ACTION Registry-GWTG/NCDR registries. International Journal of Cardiology. 2014 Aug 1;175(2):240–247.
Journal cover image

Published In

International Journal of Cardiology

DOI

EISSN

1874-1754

ISSN

0167-5273

Publication Date

August 1, 2014

Volume

175

Issue

2

Start / End Page

240 / 247

Related Subject Headings

  • Cardiovascular System & Hematology
  • 3201 Cardiovascular medicine and haematology
  • 1117 Public Health and Health Services
  • 1102 Cardiorespiratory Medicine and Haematology