Heart : official journal of the British Cardiac Society
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Review
Where are we today? Early results from MINAP, the National Audit of Myocardial Infarction Project.
The Myocardial Infarction National Audit Project (MINAP) was developed primarily as a response by the profession to the audit requirements of the National Service Framework for coronary heart disease. MINAP began to collect data in October 2000 and by October 2002, 223 hospitals in England and Wales had returned data on patients with acute myocardial infarction. ⋯ At the same time only 37% of patients received treatment within 60 minutes of calling for help, and only about 20% reached hospital within 30 minutes of calling for help. In order to improve speed of access to thrombolytic treatment there is a need for increased use of pre-hospital treatment.
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Pharmacists are not yet fully integrated into the primary health care team and their skills could be better used to help patients with their long term medicines. The government is encouraging the setting up of medicines management services. ⋯ They are also involved in smoking cessation services. Practice based pharmacists can improve patient care through medication review clinics.
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Various risk stratification systems have been developed in coronary artery bypass graft surgery (CABG), based mainly on patients undergoing procedures with cardiopulmonary bypass. ⋯ The UK CABG Bayes model is reasonably well calibrated and provides good discrimination when applied to OPCAB patients in the UK. Among the other three systems, the ACC/AHA system is well calibrated but its discrimination power was less than for the UK CABG Bayes model. These data suggest that the UK CABG Bayes model could be an appropriate risk stratification system to use for patients undergoing OPCAB in the UK.