Hospital participation in clinical trials for patients with acute myocardial infarction: Results from the National Cardiovascular Data Registry

Little is known about the proportion of hospitals in the United States that offer clinical trial enrollment opportunities and how patient outcomes differ between hospitals that do and do not participate in clinical trials. In the nationwide Chest Pain–MI registry, we described the proportion of hosp...

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Bibliographic Details
Published in:The American heart journal 2019-08, Vol.214, p.184-193
Main Authors: Fanaroff, Alexander C., Vora, Amit N., Chen, Anita Y., Mathews, Robin, Udell, Jacob A., Roe, Matthew T., Thomas, Laine E., Wang, Tracy Y.
Format: Article
Language:English
Subjects:
Aged
Cerebral infarction
Clinical outcomes
Clinical trials
Clinical Trials as Topic - statistics & numerical data
Congestive heart failure
Data dictionaries
Enrollments
Family medical history
Female
Government programs
Heart
Heart attacks
Heart failure
Hospitals
Humans
Intubation
Male
Medicaid
Medical research
Middle Aged
Mortality
Myocardial infarction
Myocardial Infarction - complications
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Pain
Participation
Patient Selection
Patients
Registries - statistics & numerical data
Regulatory approval
Stroke
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Summary:Little is known about the proportion of hospitals in the United States that offer clinical trial enrollment opportunities and how patient outcomes differ between hospitals that do and do not participate in clinical trials. In the nationwide Chest Pain–MI registry, we described the proportion of hospitals that enrolled patients with acute myocardial infarction (MI) in clinical trials from 2009 to 2014. Hospital-level adherence to every eligible MI performance measure was compared between hospitals that did and did not enroll patients in clinical trials. Using linked Medicare data, we also compared 1-year major adverse cardiovascular events (MACE: death, MI, heart failure, or stroke) among patients ≥65 years old treated at trial versus nontrial hospitals. Among 766 hospitals, 430 (56.1%) enrolled ≥1 MI patient in a clinical trial during the study period, but the proportion of hospitals enrolling patients in clinical trials declined from 36.8% in 2009 to 26.6% in 2014. Complete adherence to performance measures was delivered to a greater proportion of patients at trial hospitals than nontrial hospitals (72.6% vs 64.9%, P 
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2019.05.011