Background. Following an acute coronary syndrome (ACS), the annual risk of recurrent acute coronary syndrome or death is approximately 6-9% despite contemporary treatments (percutaneous coronary intervention, dual antiplatelet therapy and standard secondary prevention, including statins, beta blockers and ACE inhibitors).

In recent years, many new strategies have been shown to further reduce the risk of cardiovascular death in patients with coronary artery disease and these are recommended in the 2019 ESC guideline for chronic coronary syndromes.

Novel medications for diabetes (SGLT2 inhibitors and GLP-1 agonists) and lipids (ezetimibe and PCSK-9 inhibitors) have demonstrated reductions in adverse cardiovascular events in patients with coronary artery disease.

With treatment regimens becoming increasingly complex, it can be unclear which drugs are being used for each patient. This highly granular dataset of >61,000 patients under investigation for or with confirmed ACS would enable projects to assess guideline compliance, drug related adverse events and modelling to identify responder and non-responder subgroups.

PIONEER geography: The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

EHR: UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 100 ITU bed capacity including a dedicated cardiac HDU and ITU. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: ALL patients being investigated or treated for coronary artery disease and acute coronary syndromes focusing on myocardial infarction and unstable angina from 2019 onwards. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics, co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (timings, admissions, wards), presenting complaint, physiology readings (blood pressure, respiratory rate, heart rate, height, weight), Lab analysis results (EGFR, cholesterol, lactate, platelets, white blood cells and others), drug allergies, drug administered and all outcomes.

Available supplementary data: Matched controls; ambulance, OMOP data, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.