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Hospital participation in clinical trials for patients with acute myocardial infarction: Results from the National Cardiovascular Data Registry.

Publication ,  Journal Article
Fanaroff, AC; Vora, AN; Chen, AY; Mathews, R; Udell, JA; Roe, MT; Thomas, LE; Wang, TY
Published in: Am Heart J
August 2019

BACKGROUND: Little is known about the proportion of hospitals in the United States that offer clinical trial enrollment opportunities and how patient outcomes differ between hospitals that do and do not participate in clinical trials. METHODS: In the nationwide Chest Pain-MI registry, we described the proportion of hospitals that enrolled patients with acute myocardial infarction (MI) in clinical trials from 2009 to 2014. Hospital-level adherence to every eligible MI performance measure was compared between hospitals that did and did not enroll patients in clinical trials. Using linked Medicare data, we also compared 1-year major adverse cardiovascular events (MACE: death, MI, heart failure, or stroke) among patients ≥65 years old treated at trial versus nontrial hospitals. RESULTS: Among 766 hospitals, 430 (56.1%) enrolled ≥1 MI patient in a clinical trial during the study period, but the proportion of hospitals enrolling patients in clinical trials declined from 36.8% in 2009 to 26.6% in 2014. Complete adherence to performance measures was delivered to a greater proportion of patients at trial hospitals than nontrial hospitals (72.6% vs 64.9%, P < .001; adjusted OR 1.07, 95% CI 1.03-1.12). One-year MACE rates were also lower for trial hospitals (adjusted HR 0.96, 95% CI 0.93-0.99). CONCLUSIONS: Hospitals are becoming less likely to engage in clinical trials for patients with MI. Patients admitted to hospitals that participated in clinical trials more often received guideline-adherent care and had better long-term outcomes.

Duke Scholars

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Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

August 2019

Volume

214

Start / End Page

184 / 193

Location

United States

Related Subject Headings

  • Registries
  • Patient Selection
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
  • Clinical Trials as Topic
  • Cardiovascular System & Hematology
  • Aged
 

Citation

APA
Chicago
ICMJE
MLA
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Fanaroff, A. C., Vora, A. N., Chen, A. Y., Mathews, R., Udell, J. A., Roe, M. T., … Wang, T. Y. (2019). Hospital participation in clinical trials for patients with acute myocardial infarction: Results from the National Cardiovascular Data Registry. Am Heart J, 214, 184–193. https://doi.org/10.1016/j.ahj.2019.05.011
Fanaroff, Alexander C., Amit N. Vora, Anita Y. Chen, Robin Mathews, Jacob A. Udell, Matthew T. Roe, Laine E. Thomas, and Tracy Y. Wang. “Hospital participation in clinical trials for patients with acute myocardial infarction: Results from the National Cardiovascular Data Registry.Am Heart J 214 (August 2019): 184–93. https://doi.org/10.1016/j.ahj.2019.05.011.
Fanaroff AC, Vora AN, Chen AY, Mathews R, Udell JA, Roe MT, et al. Hospital participation in clinical trials for patients with acute myocardial infarction: Results from the National Cardiovascular Data Registry. Am Heart J. 2019 Aug;214:184–93.
Fanaroff, Alexander C., et al. “Hospital participation in clinical trials for patients with acute myocardial infarction: Results from the National Cardiovascular Data Registry.Am Heart J, vol. 214, Aug. 2019, pp. 184–93. Pubmed, doi:10.1016/j.ahj.2019.05.011.
Fanaroff AC, Vora AN, Chen AY, Mathews R, Udell JA, Roe MT, Thomas LE, Wang TY. Hospital participation in clinical trials for patients with acute myocardial infarction: Results from the National Cardiovascular Data Registry. Am Heart J. 2019 Aug;214:184–193.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

August 2019

Volume

214

Start / End Page

184 / 193

Location

United States

Related Subject Headings

  • Registries
  • Patient Selection
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
  • Clinical Trials as Topic
  • Cardiovascular System & Hematology
  • Aged