Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients: A cohort study using English linked electronic health data

Briana Coles; Lucy Teece; Clive Weston; Mark A. de Belder; Clare Oliver-Williams; Catherine A. Welch; Mark J. Rutherford; Paul C. Lambert; Patrick Bidulka; Lizz Paley; Dorothea Nitsch; John Deanfield; Mick D. Peake; David Adlam; Michael J. Sweeting

doi:10.1093/ehjqcco/qcab045

Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients: A cohort study using English linked electronic health data

Briana Coles, Lucy Teece, Clive Weston, Mark A. de Belder, Clare Oliver-Williams, Catherine A. Welch, Mark J. Rutherford, Paul C. Lambert, Patrick Bidulka, Lizz Paley, Dorothea Nitsch, John Deanfield, Mick D. Peake, David Adlam, Michael J. Sweeting

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

21 Downloads (Pure)

Abstract

AIMS: To assess the recording and accuracy of acute myocardial infarction (AMI) hospital admissions between two electronic health record databases within an English cancer population over time and understand the factors that affect case-ascertainment.

METHODS AND RESULTS: We identified 112 502 hospital admissions for AMI in England 2010-2017 from the Myocardial Ischaemia National Audit Project (MINAP) disease registry and hospital episode statistics (HES) for 95 509 patients with a previous cancer diagnosis up to 15 years prior to admission. Cancer diagnoses were identified from the National Cancer Registration Dataset (NCRD). We calculated the percentage of AMI admissions captured by each source and examined patient characteristics associated with source of ascertainment. Survival analysis assessed whether differences in survival between case-ascertainment sources could be explained by patient characteristics. A total of 57 265 (50.9%) AMI admissions in patients with a prior diagnosis of cancer were captured in both MINAP and HES. Patients captured in both sources were younger, more likely to have ST-segment elevation myocardial infarction and had better prognosis, with lower mortality rates up to 9 years after AMI admission compared with patients captured in only one source. The percentage of admissions captured in both data sources improved over time. Cancer characteristics (site, stage, and grade) had little effect on how AMI was captured.

CONCLUSION: MINAP and HES define different populations of patients with AMI. However, cancer characteristics do not substantially impact on case-ascertainment. These findings support a strategy of using multiple linked data sources for observational cardio-oncological research into AMI.

Original language	English
Pages (from-to)	86-95
Number of pages	10
Journal	European Heart Journal - Quality of Care and Clinical Outcomes
Volume	8
Issue number	1
Early online date	22 Jun 2021
DOIs	https://doi.org/10.1093/ehjqcco/qcab045
Publication status	Published - 5 Jan 2022

Bibliographical note

Funding Information: This study was jointly funded by Cancer Research UK (C53325/A21134) and the British Heart Foundation (SP/16/5/32415). This project was supported by funding from the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. P.B. is partly funded by Kidney Research UK (IN_008_20180304) and the Health Foundation (1725841). The funders had no role in the study design, in the collection, analysis or interpretation of the data, in the writing of the report or in the decision to submit the article for publication.

M.J.S., B.C., C.O.W., C.A.W., L.T., M.J.R., P.C.L., D.A., M.D.P. had financial support from British Heart Foundation and Cancer Research UK for the submitted work; P.B. is partly funded by Kidney Research UK and Health Foundation for research related to this work; D.A. has received research funding and in kind support for unrelated research from AstraZeneca and an educational grant from Abbott Vascular for unrelated research. He has conducted consultancy for GE for unrelated research; B.C. was funded by a grant from Novo Nordisk; J.D. had financial support from the British Heart Foundation; C.W. is Clinical Lead of the Myocardial Ischaemia National Audit Project (MINAP); M.A.d.B. reports DSMB membership of the UK GRIS Trial, chair of the ARREST Trial Steering Committee and Executive Member of the DAPA-MI Trial; C.A.W. reports consulting fees from Bart’s Health NHS Trust and payment from University College London; no other relationships or activities that could appear to have influenced the submitted work.

Open Access: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

Citation: Briana Coles, Lucy Teece, Clive Weston, Mark A de Belder, Clare Oliver-Williams, Catherine A Welch, Mark J Rutherford, Paul C Lambert, Patrick Bidulka, Lizz Paley, Dorothea Nitsch, John Deanfield, Mick D Peake, David Adlam, Michael J Sweeting, on behalf of the VICORI collaborative, Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients: a cohort study using English linked electronic health data, European Heart Journal - Quality of Care and Clinical Outcomes, Volume 8, Issue 1, January 2022, Pages 86–95,

DOI: https://doi.org/10.1093/ehjqcco/qcab045

Keywords

Cancer
Cardio-oncology
Case-ascertainment
HES
MINAP
Myocardial infarction

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/ehjqcco/qcab045Licence: CC BY

Coles2021Case-AscertainmentofAcuteMyocardialInfarctionHospitalizationsEurHeartJQualCareClinOutcomesFinal published version, 669 KBLicence: CC BY

Cite this

Coles, B., Teece, L., Weston, C., de Belder, M. A., Oliver-Williams, C., Welch, C. A., Rutherford, M. J., Lambert, P. C., Bidulka, P., Paley, L., Nitsch, D., Deanfield, J., Peake, M. D., Adlam, D., & Sweeting, M. J. (2022). Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients: A cohort study using English linked electronic health data. European Heart Journal - Quality of Care and Clinical Outcomes, 8(1), 86-95. https://doi.org/10.1093/ehjqcco/qcab045

@article{be69742d94d841e3a8aedad802ceb9a3,

title = "Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients: A cohort study using English linked electronic health data",

abstract = "AIMS: To assess the recording and accuracy of acute myocardial infarction (AMI) hospital admissions between two electronic health record databases within an English cancer population over time and understand the factors that affect case-ascertainment. METHODS AND RESULTS: We identified 112 502 hospital admissions for AMI in England 2010-2017 from the Myocardial Ischaemia National Audit Project (MINAP) disease registry and hospital episode statistics (HES) for 95 509 patients with a previous cancer diagnosis up to 15 years prior to admission. Cancer diagnoses were identified from the National Cancer Registration Dataset (NCRD). We calculated the percentage of AMI admissions captured by each source and examined patient characteristics associated with source of ascertainment. Survival analysis assessed whether differences in survival between case-ascertainment sources could be explained by patient characteristics. A total of 57 265 (50.9%) AMI admissions in patients with a prior diagnosis of cancer were captured in both MINAP and HES. Patients captured in both sources were younger, more likely to have ST-segment elevation myocardial infarction and had better prognosis, with lower mortality rates up to 9 years after AMI admission compared with patients captured in only one source. The percentage of admissions captured in both data sources improved over time. Cancer characteristics (site, stage, and grade) had little effect on how AMI was captured. CONCLUSION: MINAP and HES define different populations of patients with AMI. However, cancer characteristics do not substantially impact on case-ascertainment. These findings support a strategy of using multiple linked data sources for observational cardio-oncological research into AMI.",

keywords = "Cancer, Cardio-oncology, Case-ascertainment, HES, MINAP, Myocardial infarction",

author = "Briana Coles and Lucy Teece and Clive Weston and {de Belder}, {Mark A.} and Clare Oliver-Williams and Welch, {Catherine A.} and Rutherford, {Mark J.} and Lambert, {Paul C.} and Patrick Bidulka and Lizz Paley and Dorothea Nitsch and John Deanfield and Peake, {Mick D.} and David Adlam and Sweeting, {Michael J.}",

note = "Funding Information: This study was jointly funded by Cancer Research UK (C53325/A21134) and the British Heart Foundation (SP/16/5/32415). This project was supported by funding from the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. P.B. is partly funded by Kidney Research UK (IN_008_20180304) and the Health Foundation (1725841). The funders had no role in the study design, in the collection, analysis or interpretation of the data, in the writing of the report or in the decision to submit the article for publication. M.J.S., B.C., C.O.W., C.A.W., L.T., M.J.R., P.C.L., D.A., M.D.P. had financial support from British Heart Foundation and Cancer Research UK for the submitted work; P.B. is partly funded by Kidney Research UK and Health Foundation for research related to this work; D.A. has received research funding and in kind support for unrelated research from AstraZeneca and an educational grant from Abbott Vascular for unrelated research. He has conducted consultancy for GE for unrelated research; B.C. was funded by a grant from Novo Nordisk; J.D. had financial support from the British Heart Foundation; C.W. is Clinical Lead of the Myocardial Ischaemia National Audit Project (MINAP); M.A.d.B. reports DSMB membership of the UK GRIS Trial, chair of the ARREST Trial Steering Committee and Executive Member of the DAPA-MI Trial; C.A.W. reports consulting fees from Bart{\textquoteright}s Health NHS Trust and payment from University College London; no other relationships or activities that could appear to have influenced the submitted work. Open Access: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. Publisher Copyright: {\textcopyright} The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. Citation: Briana Coles, Lucy Teece, Clive Weston, Mark A de Belder, Clare Oliver-Williams, Catherine A Welch, Mark J Rutherford, Paul C Lambert, Patrick Bidulka, Lizz Paley, Dorothea Nitsch, John Deanfield, Mick D Peake, David Adlam, Michael J Sweeting, on behalf of the VICORI collaborative, Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients: a cohort study using English linked electronic health data, European Heart Journal - Quality of Care and Clinical Outcomes, Volume 8, Issue 1, January 2022, Pages 86–95, DOI: https://doi.org/10.1093/ehjqcco/qcab045",

year = "2022",

month = jan,

day = "5",

doi = "10.1093/ehjqcco/qcab045",

language = "English",

volume = "8",

pages = "86--95",

journal = "European Heart Journal - Quality of Care and Clinical Outcomes",

issn = "2058-5225",

publisher = "Oxford University Press",

number = "1",

}

Coles, B, Teece, L, Weston, C, de Belder, MA, Oliver-Williams, C, Welch, CA, Rutherford, MJ, Lambert, PC, Bidulka, P, Paley, L, Nitsch, D, Deanfield, J, Peake, MD, Adlam, D & Sweeting, MJ 2022, 'Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients: A cohort study using English linked electronic health data', European Heart Journal - Quality of Care and Clinical Outcomes, vol. 8, no. 1, pp. 86-95. https://doi.org/10.1093/ehjqcco/qcab045

Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients: A cohort study using English linked electronic health data. / Coles, Briana; Teece, Lucy; Weston, Clive et al.
In: European Heart Journal - Quality of Care and Clinical Outcomes, Vol. 8, No. 1, 05.01.2022, p. 86-95.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients

T2 - A cohort study using English linked electronic health data

AU - Coles, Briana

AU - Teece, Lucy

AU - Weston, Clive

AU - de Belder, Mark A.

AU - Oliver-Williams, Clare

AU - Welch, Catherine A.

AU - Rutherford, Mark J.

AU - Lambert, Paul C.

AU - Bidulka, Patrick

AU - Paley, Lizz

AU - Nitsch, Dorothea

AU - Deanfield, John

AU - Peake, Mick D.

AU - Adlam, David

AU - Sweeting, Michael J.

N1 - Funding Information: This study was jointly funded by Cancer Research UK (C53325/A21134) and the British Heart Foundation (SP/16/5/32415). This project was supported by funding from the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands (ARC EM). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. P.B. is partly funded by Kidney Research UK (IN_008_20180304) and the Health Foundation (1725841). The funders had no role in the study design, in the collection, analysis or interpretation of the data, in the writing of the report or in the decision to submit the article for publication. M.J.S., B.C., C.O.W., C.A.W., L.T., M.J.R., P.C.L., D.A., M.D.P. had financial support from British Heart Foundation and Cancer Research UK for the submitted work; P.B. is partly funded by Kidney Research UK and Health Foundation for research related to this work; D.A. has received research funding and in kind support for unrelated research from AstraZeneca and an educational grant from Abbott Vascular for unrelated research. He has conducted consultancy for GE for unrelated research; B.C. was funded by a grant from Novo Nordisk; J.D. had financial support from the British Heart Foundation; C.W. is Clinical Lead of the Myocardial Ischaemia National Audit Project (MINAP); M.A.d.B. reports DSMB membership of the UK GRIS Trial, chair of the ARREST Trial Steering Committee and Executive Member of the DAPA-MI Trial; C.A.W. reports consulting fees from Bart’s Health NHS Trust and payment from University College London; no other relationships or activities that could appear to have influenced the submitted work. Open Access: This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. Citation: Briana Coles, Lucy Teece, Clive Weston, Mark A de Belder, Clare Oliver-Williams, Catherine A Welch, Mark J Rutherford, Paul C Lambert, Patrick Bidulka, Lizz Paley, Dorothea Nitsch, John Deanfield, Mick D Peake, David Adlam, Michael J Sweeting, on behalf of the VICORI collaborative, Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients: a cohort study using English linked electronic health data, European Heart Journal - Quality of Care and Clinical Outcomes, Volume 8, Issue 1, January 2022, Pages 86–95, DOI: https://doi.org/10.1093/ehjqcco/qcab045

PY - 2022/1/5

Y1 - 2022/1/5

N2 - AIMS: To assess the recording and accuracy of acute myocardial infarction (AMI) hospital admissions between two electronic health record databases within an English cancer population over time and understand the factors that affect case-ascertainment. METHODS AND RESULTS: We identified 112 502 hospital admissions for AMI in England 2010-2017 from the Myocardial Ischaemia National Audit Project (MINAP) disease registry and hospital episode statistics (HES) for 95 509 patients with a previous cancer diagnosis up to 15 years prior to admission. Cancer diagnoses were identified from the National Cancer Registration Dataset (NCRD). We calculated the percentage of AMI admissions captured by each source and examined patient characteristics associated with source of ascertainment. Survival analysis assessed whether differences in survival between case-ascertainment sources could be explained by patient characteristics. A total of 57 265 (50.9%) AMI admissions in patients with a prior diagnosis of cancer were captured in both MINAP and HES. Patients captured in both sources were younger, more likely to have ST-segment elevation myocardial infarction and had better prognosis, with lower mortality rates up to 9 years after AMI admission compared with patients captured in only one source. The percentage of admissions captured in both data sources improved over time. Cancer characteristics (site, stage, and grade) had little effect on how AMI was captured. CONCLUSION: MINAP and HES define different populations of patients with AMI. However, cancer characteristics do not substantially impact on case-ascertainment. These findings support a strategy of using multiple linked data sources for observational cardio-oncological research into AMI.

AB - AIMS: To assess the recording and accuracy of acute myocardial infarction (AMI) hospital admissions between two electronic health record databases within an English cancer population over time and understand the factors that affect case-ascertainment. METHODS AND RESULTS: We identified 112 502 hospital admissions for AMI in England 2010-2017 from the Myocardial Ischaemia National Audit Project (MINAP) disease registry and hospital episode statistics (HES) for 95 509 patients with a previous cancer diagnosis up to 15 years prior to admission. Cancer diagnoses were identified from the National Cancer Registration Dataset (NCRD). We calculated the percentage of AMI admissions captured by each source and examined patient characteristics associated with source of ascertainment. Survival analysis assessed whether differences in survival between case-ascertainment sources could be explained by patient characteristics. A total of 57 265 (50.9%) AMI admissions in patients with a prior diagnosis of cancer were captured in both MINAP and HES. Patients captured in both sources were younger, more likely to have ST-segment elevation myocardial infarction and had better prognosis, with lower mortality rates up to 9 years after AMI admission compared with patients captured in only one source. The percentage of admissions captured in both data sources improved over time. Cancer characteristics (site, stage, and grade) had little effect on how AMI was captured. CONCLUSION: MINAP and HES define different populations of patients with AMI. However, cancer characteristics do not substantially impact on case-ascertainment. These findings support a strategy of using multiple linked data sources for observational cardio-oncological research into AMI.

KW - Cancer

KW - Cardio-oncology

KW - Case-ascertainment

KW - HES

KW - MINAP

KW - Myocardial infarction

UR - http://www.scopus.com/inward/record.url?scp=85123325357&partnerID=8YFLogxK

U2 - 10.1093/ehjqcco/qcab045

DO - 10.1093/ehjqcco/qcab045

M3 - Article

C2 - 34156470

AN - SCOPUS:85123325357

SN - 2058-5225

VL - 8

SP - 86

EP - 95

JO - European Heart Journal - Quality of Care and Clinical Outcomes

JF - European Heart Journal - Quality of Care and Clinical Outcomes

IS - 1

ER -

Case-ascertainment of acute myocardial infarction hospitalizations in cancer patients: A cohort study using English linked electronic health data

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this