Myocardial Ischaemia National Audit Project - University College ...

This year we report on the interval between admission andperformance of angiography. While immediate angiographyis not warranted in the vast majority of patients with nSTEMI,early angiography is recommended for those at moderate tohigh risk. The maximum acceptable delay from admission toangiogram has been variously defined. So, for example theEuropean Society of Cardiology suggests a 72 hour maximum,while NICE suggests a 96 hour maximum. Figure 17 shows ageneral improvement over the last year. Between 2010/11 and2011/12 the proportion of patients receiving angiography within24 hours of admission increased from 21% to 22%; within72 hours from 55% to 58%; and within 96 hours from 67%to 71%. However, 29% of patients with nSTEMI who receivean angiogram do so after the maximum recommended timeinterval (i.e. 96 hours) compared to 33% in 2010/11.Figure 20. 30 day mortality (with 95% confidence limitsaround the point estimate within each year) for nSTEMI%141210864209. Change in mortality of heart attack patients2003-42004-52005-6Figure 19. 30 day mortality (with 95% confidence limitsaround the point estimate within each year) for all patientshaving STEMI1412Over the last 8 years there have been gradual reduction in thereported death rates for patients within the MINAP dataset,both those with a final diagnosis of STEMI (Figure 19) andnSTEMI (Figure 20).10%864202003-42004-52005-62006-72006-72007-8Year2007-82008-92009-102010-112011-122008-92009-102010-112011-12YearMINAP Eleventh Public Report 201227