Myocardial ischaemia: 9/10 of heart attack cases seen on time MINAP audit finds

Published: 30 Jan 2017

999-to-treatment times improve by almost 40% in the last decade, according to national clinical audit report.

View full report here

The latest Myocardial Ischaemia National Audit Project (MINAP) report published today, has shown significant improvements in key indicators for heart attack patients, and also highlights the serious impact of smoking on the onset of heart attack.

Commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit Programme, the MINAP audit reports on data collected from 217 hospitals, across England, Wales and Northern Ireland, in the 2014/15 period.

Wide reaching participation with centres in the audit provides us with an accurate representation of treatment of heart attack across the country, enabling NICOR to provide results that reflect the healthcare system as a whole, thus providing good clinical data that initiates quality improvement, to provide better patient outcomes.

Treatment for Heart Attack

Primary PCI (Percutaneous Coronary Intervention) has been established as best practice for re- opening the blocked arteries that cause a heart attack. 9 out of 10 patients that suffer a heart attack in England (99%) and Northern Ireland (92%), receive PCI treatment. In Wales 80% of patients receive PCI, up from 30% in 2010-11 as more centres establish PCI capabilities:

A key performance measure, ‘call-to-balloon’ time (CTB) is the interval between the call for professional help (ambulance) and the start of primary PCI treatment. The MINAP audit found that 89% of patients are treated with primary PCI within 90 minutes of arrival at hospital – the equivalent figure being 52% years ago (2004-2005).

 Dr Clive Weston (Consultant Cardiologist & MINAP audit clinical lead) said:

 ‘We have witnessed improvements in a number of aspects related to the quality of care for patients following a heart attack in recent years. That being said, there is still considerable scope for further improvement. Call to balloon times are generally reducing however, it would be great to see a reduction in the time taken for an ambulance to be called after that first noticeable symptom occurring. Educating the public on those early warning signs and how to react to them is the key’.

The report also addresses the health related risk factors associated with heart attacks. Unsurprisingly, smokers in the UK that experience a heart attack are, on average, over ten years younger than non- smokers.

 “The average age at the time of heart attack is 57.9 years for male smokers compared with 68.1 years for men who have never smoked. The average age at the time of heart attack is 62.4 years for female smokers compared with 76.5 years for women who have never smoked.” MINAP 2014-15

Recommendations from the Report

The Myocardial Ischaemia National Audit Project (MINAP) measures the performance of hospitals that treat heart attack in the UK against best practice. The 14th annual report covers over 90,000 patient records, of which 83,842 had a final diagnosis of heart attack (myocardial infarction).

The MINAP provides valuable information on the performance of hospitals on an individual level while also having the scope to illustrate performance trends on a national scale. This wealth of data allows Medical Directors to identify areas for improvement, to effect change within their trust; while giving direction to CCGs and policy makers to implement initiatives on a regional or national scale, leading to better patient outcomes.

We should seek to create a dialogue with the general public, to increase the awareness of the risk factors for heart attack. But most importantly, to increase recognition of the early symptoms of heart attack so that care can be given sooner and a better outcome achieved.