Healthcare utilisation and clinical outcomes among survivors of acute myocardial infarction: a national electronic health records cohort study (360G-Wellcome-206470_Z_17_Z)

Although cardiovascular disease remains the leading cause of death worldwide, survival following acute myocardial infarction (AMI) has improved dramatically in recent decades. AMI patients are predominantly elderly and multi-morbid, yet little is known about the impact of their multi-morbidity upon receipt of guideline recommended care. Moreover, increased survivorship is associated with an increased risk of recurrent events and future co-morbidities. To date, data about the healthcare burden following AMI have been limited to either the acute hospital setting only, or restricted to cardiovascular related events. Therefore, I aim to investigate the total cardiovascular and non-cardiovascular healthcare burden among AMI survivors using large scale electronic healthcare databases covering in-hospital and primary care patient pathways. Quantifying the association between the receipt of guideline care and existing multi-morbidities for patients with AMI will help target therapeutic strategies to specific groups of patients to further reduce premature mortality from AMI. In addition, characterising the incidence and nature of primary and secondary care visits following AMI across a spectrum of outcomes will lead to increased understanding of disease progression and can be used to inform the selection of new clinical trial endpoints as well as aid data driven medicine for the development of guidelines.