Resuscitated cardiac arrest and prognosis following myocardial infarction.

Objectives: To determine whether resuscitated cardiac arrest (CA) complicating ST elevation myocardial infarction (STEMI) impacts outcome, particularly in patients surviving to discharge.

Background: Resuscitated CA complicating STEMI is associated with increased inpatient mortality. The impact on later prognosis is unclear.

The importance of audit to monitor applications of procedures and improve primary angioplasty results.

Although clinical trials have demonstrated that primary percutaneous coronary intervention (PPCI) provides better outcomes than thrombolysis for STEMI, it cannot be assumed that similar results can be obtained in day-to-day practice. To determine whether standards are being met, continuous audit of PPCI programmes is necessary, with appropriate feedback to participating centres and operators. Both the MINAP and BCIS national audit projects allow central electronic collection of data on consecutive patients presenting to every hospital involved in the acute management of these patients.

Impact of specialty of admitting physician and type of hospital on care and outcome for myocardial infarction in England and Wales during 2004-5: observational study.

Objective: To examine process of care and outcome for patients admitted with acute myocardial infarction to hospitals in England and Wales in relation to type of consultant care and type of hospital.

Design: Observational study of 88,782 patients admitted with myocardial infarction during 2004-5, using records from the national audit of myocardial infarction project (MINAP) database.

Outcome Measures: Use of reperfusion treatment and secondary prevention drugs, use of angiography, and 90 day mortality of patients admitted under the care of cardiologists and non-cardiologists in hospitals with and without facilities for coronary intervention.

Developing a rapid access chest pain clinic: qualitative studies of patients' needs and experiences.

Objective: The aims of this study are to understand the needs and experiences of rapid access chest pain clinic attenders and to determine the acceptability and effectiveness of simple procedural changes.

Methods: Two qualitative studies of clinic attenders before and after procedural changes which were guided by the first study.

Results: Study 1: Patients wanted to be reassured, by knowing what was causing their pain, understanding the cause, and feeling able to help themselves.