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Version: 1.0.0 | Published: 8 Oct 2024 | Updated: 229 days ago

Investigations, interventions, and outcomes for acute coronary syndrome

Dataset

Documentation

Description:
Background. Following an acute coronary syndrome (ACS), the annual risk of recurrent acute coronary syndrome or death is approximately 6-9% despite contemporary treatments (percutaneous coronary intervention, dual antiplatelet therapy and standard secondary prevention, including statins, beta blockers and ACE inhibitors). In recent years, many new strategies have been shown to further reduce the risk of cardiovascular death in patients with coronary artery disease and these are recommended in the 2019 ESC guideline for chronic coronary syndromes. Novel medications for diabetes (SGLT2 inhibitors and GLP-1 agonists) and lipids (ezetimibe and PCSK-9 inhibitors) have demonstrated reductions in adverse cardiovascular events in patients with coronary artery disease. With treatment regimens becoming increasingly complex, it can be unclear which drugs are being used for each patient. This highly granular dataset of >61,000 patients under investigation for or with confirmed ACS would enable projects to assess guideline compliance, drug related adverse events and modelling to identify responder and non-responder subgroups. PIONEER geography: The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix. EHR: UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 100 ITU bed capacity including a dedicated cardiac HDU and ITU. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”. Scope: ALL patients being investigated or treated for coronary artery disease and acute coronary syndromes focusing on myocardial infarction and unstable angina from 2019 onwards. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics, co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (timings, admissions, wards), presenting complaint, physiology readings (blood pressure, respiratory rate, heart rate, height, weight), Lab analysis results (EGFR, cholesterol, lactate, platelets, white blood cells and others), drug allergies, drug administered and all outcomes. Available supplementary data: Matched controls; ambulance, OMOP data, synthetic data. Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.

Coverage

Spatial:
United Kingdom,England,West Midlands
Typical Age Range:
17-110
Follow Up:
1 - 10 Years
Pathway:
Data is representative of the multi-ethnicity population within the West Midlands (42% non white). Data includes all patients admitted during this timeframe, with National data Opt Outs applied, and therefore is representative of admissions to secondary care. Data focuses on in-patient stay in hospital during the acute episode but can be supplemented on request to include previous and subsequent hospital contacts (including outpatient appointments) and ambulance, 111, 999 data.

Provenance

Origin

Purposes:
Care
Sources:
EPR
Collection Situations:
  • Secondary care - In-patients
  • Secondary care - Outpatients
  • Secondary care - Accident and Emergency

Temporal

Accrual Periodicity:
Quarterly
Distribution Release Date:
16 December 2021
Start Date:
01 January 2019
End Date:
16 December 2021
Time Lag:
Other

Accessibility

Access

Access Service:
Trusted Research Environments (TRE) are built using Microsoft Azure services and hosted in the UK to provide research teams a safe, secure and agile environment which allows users to quickly analyse, interpret and form an enriched view of primary care information through a range of integrated datasets. Health data collated from multiple sources is ingested into a secure data lake which will then allow subsets of data to be made available to research teams on approval of a data request. Once approved a customer specific TRE is made available with a standard set of leading analytical tools from Microsoft including Azure Databricks, Azure Machine Learning, Azure SQL and Azure Synapse (for large-scale data warehouses). Specific tools can be provided at an additional cost over the standard platform data access charge and the PIONEER team will work with you to determine your exact needs. Access to the TRE is managed using the latest virtual desktop technology to provide a safe and secure end-user experience. By utilising leading edge design PIONEER are able to create TREs rapidly to enable us to service any customer requirement.
Access Request Cost:
www.pioneerdatahub.co.uk/data/data-services-costs/
Delivery Lead Time:
Not applicable
Jurisdictions:
GB-ENG
Data Controller:
University Hospitals Birmingham NHS Foundation Trust

Usage

Data Use Limitations:
General research use
Data Use Requirements:
Project-specific restrictions
Resource Creators:
This publication uses data from PIONEER, an ethically approved database and analytical environment (East Midlands Derby Research Ethics 20/EM/0158)

Format and Standards

Vocabulary Encoding Schemes:
  • SNOMED CT
  • ICD10
Conforms To:
LOCAL
Languages:
en
Formats:
SQL

Observations

Statistical Population
Population Description
Population Size
Measured Property
Observation Date
Persons
61,476 admissions for patients with myocardial infarction and unstable angina
61476
Count
16 December 2021