National Institute for Health and Care Excellence (NICE) guidelines clearly state how to treat most people hospitalised with a heart attack, particularly people hospitalised for a heart attack involving a complete blockage of one of the heart’s main blood vessels (ST-elevated myocardial infarction (STEMI)).
However, the guidelines are not clear for people living with chronic conditions like kidney disease hospitalised for the more common type of heart attack usually involving an incomplete blockage of one of the heart’s main blood vessels (non-ST-elevated myocardial infarction (NSTEMI)).
This leads to substantial variation in NSTEMI heart attack treatment for people with kidney disease, because there is uncertainty about which type of heart attack treatment is best for people with kidney disease.
The impact of the COVID-19 pandemic on this variation in treatment is currently unknown.
The aim of this research is to compare the variation in heart attack treatments among people with reduced kidney function in England before and after the COVID-19 pandemic, and to then use this variation to compare the clinical benefits and risks, as well as the costs to the National Health Service (NHS) of different heart attack treatments among people with impaired kidney function. We will focus on a broader population of people with reduced kidney function rather than just people with a chronic kidney disease diagnosis.
This research will use the large de-identified data from the BHF Data Science Centre, linked between primary care, secondary care, and other health data, to get a good understanding of how people with impaired kidney function are treated for heart attacks across England, and how we can improve treatment to benefit patients and reduce costs for the NHS.
This work will highlight the substantial variation and differences in heart attack treatment for people with reduced kidney function, and how we can balance the risks and benefits of different heart attack treatments among this vulnerable group of people. Our research will highlight the need for more trials to compare heart attack treatments among people living with long-term health conditions, and provide valuable observational evidence in the meantime to inform policy-makers and the NHS on how best to manage people who experience these life-threatening conditions.