Spreadsheet: 0847e206-5ea6-4651-a0ec-34783dab6b70
Sheet: Sheet1

MINAP Dataset Version 10.3.1, March 2013 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10
Field number | Field Name | Short Code | Text for long code | Definition and notes | Format | E
1.01 | Hospital identifier |  |  | The identifier allocated to the hospital by NICOR. Valid hospital identifiers are listed in a separate file. | Code a3 | N
1.02 | Patient case record number |  |  | Hospital number is required for identification if the NHS number is not known. | Id an10 | Y
1.03 | NHS number |  |  | Unique national identifier that will be used for event and mortality tracking. This will be encrypted before data transfer.  Any other event or procedure recorded by NICOR will be linked using the NHS number. | Id n10 | Y
1.04 | Patient surname |  |  |  | an35 | Y
1.05 | Patient forename |  |  |  | an35 | Y
1.06 | Patient date of birth |  |  | Valid date>1880 and <=Today. | Date | Y
1.07 | Patient gender |  |  |  | Code n1 | N
 |  | 0 | Not known
 |  | 1 | Male
 |  | 2 | Female
 |  | 9 | Not specified
1.09 | Patient admin status |  |  |  | Code n1 | N
 |  | 1 | NHS | NHS patient, including overseas visitors charged under Section 121 of the NHS Act 1977 as amended by Section 7(12) and (14) of the Health and Medicine Act 1988.
 |  | 2 | Private | A private patient is any patient whose care is not funded by the NHS, wherever that care is delivered.
 |  | 3 | Amenity | Amenity patient, one who pays for the use of a single room or small ward in accord with section 12 of the NHS Act 1977, as amended by section 7(12) and (14) of the Health and Medicine Act 1988.
 |  | 9 | Unknown
1.10 | Patient postcode |  |  | The postcode of the address nominated by the patient as their main permanent residence. Use pseudo postcodes for visitors. | Id an8 | Y
1.11 | GP/ PCT code |  |  | The national code for the practice of the patient's registered GP or PCT. | Code 6 | Y
1.13 | Patient ethnicity |  |  | The patient's ethnic group as perceived by the patient. | Code n2 | N
 |  | 1 | White | Includes British, Irish, any other White background.
 |  | 2 | Black | Includes Caribbean, African, Black British, any other Black background.
 |  | 3 | Asian | Includes Indian, Pakistani, [NAME], Asian British, any other Asian background.
 |  | 5 | Mixed | Includes White and Black Caribbean, White and Black African, White and Asian, any other mixed background.
 |  | 6 | Not stated | Where the patient cannot or does not wish to state his/her ethnic background.
 |  | 8 | Other | Includes Chinese, any other ethnic group.
 |  | 9 | Unknown
2.01 | Initial diagnosis |  |  | This is a working diagnosis whose primary purpose is to identify those patients with a diagnosis of definite ST elevation MI. This includes an initial diagnosis made by an ambulance paramedic crew, or other clinician in a position to provide definitive treatment. Do not change Initial diagnosis on the basis of further ECGs or enzymes/markers. (See 2.03 ECG determining treatment). | Code n1 | N
 |  | 1 | Definite myocardial infarction | Diagnosis based on unequivocal changes of infarction on initial ECG (ST elevation or new LBBB) and appropriate history and are thus eligible for consideration for reperfusion treatment. LBBB of uncertain duration should be recorded as Acute coronary syndrome.
 |  | 3 | Acute coronary syndrome | Covers all other suspected acute coronary syndromes including cases previously categorised as 2. Probable infarction. Confirmation of diagnosis awaits results of troponin assay. Should be used where there is a strong likelihood of infarction on history and an abnormal ECG without significant ST elevation or new LBBB without ST segment elevation.
 |  | 4 | Chest pain ? cause | Single episode of chest pain thought to be cardiac in nature where admission was thought appropriate to exclude an ischaemic event. This covers all other admissions where no clear initial diagnosis has been made, but where there is an index of suspicion that the symptoms may be ischaemic in nature.
 |  | 5 | Other initial diagnosis | Other (usually non-cardiac) diagnosis such as acute aortic dissection, pancreatitis, etc where symptoms are subsequently found to be a manifestation of acute cardiac ischaemia. Use where patient is already in hospital.
2.03 | ECG determining treatment |  |  | The ECG appearances upon which a decision to offer reperfusion treatment including primary PCI, was based. This can include any 12 lead ECG performed in the pre-hospital setting. If ST elevation consistent with infarction is recorded on any ECG during the admission, regardless of treatment, the discharge diagnosis should be Myocardial infarction (ST elevation). | Code n1 | N
 |  | 0 | No acute changes | ECG is normal or unchanged from one recorded before this admission.
 |  | 1 | ST segment elevation | Appearances considered typical of acute ST elevation myocardial  infarction.
 |  | 2 | Left bundle branch block | New LBBB. Whether or not LBBB is 'new' causes practical difficulties. In order to confirm this it is necessary to have evidence that it did not exist before this event, by comparing with previous ECGs. Unless there is definite ST segment elevation in addition to LBBB, the admission diagnosis for a patient with LBBB of uncertain duration has to be Acute coronary syndrome.
 |  | 3 | ST segment depression | Any degree of ST segment depression involving more than one lead without any ST elevation (except aVR).
 |  | 4 | T wave changes only | Includes non Q wave infarction.
 |  | 5 | Other acute abnormality | Other ECG abnormality related to this acute event.
 |  | 9 | Unknown
2.04 | Where was aspirin/other antiplatelet given? |  |  | Identifies if and when aspirin or other antiplatelet drug was first given to patient. | Code n1 | N
 |  | 1 | Already on aspirin / antiplatelet drug | Regular use of aspirin/antiplatelet before this episode. Ignore the administration of additional doses by paramedics.
 |  | 2 | Aspirin / antiplatelet drug given out of hospital | Aspirin or other antiplatelet drug started for this episode before admission. Patient not previously taking any antiplatelet drug.
 |  | 3 | Aspirin / antiplatelet drug given after arrival in hospital
 |  | 4 | Aspirin / antiplatelet contraindicated
 |  | 8 | Not given
 |  | 9 | Unknown
2.05 | Previous AMI |  |  | Any previously validated episode of acute myocardial infarction. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.06 | Previous angina |  |  | Symptoms due to cardiac ischaemia developing or already in existence at least two weeks prior to admission, and continuing up to admission. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.07 | Hypertension |  |  | A patient already receiving treatment (drug, dietary or lifestyle) for hypertension or with recorded  BP > 140/90 on at least two occasions prior to admission. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.08 | Hypercholesterolaemia |  |  | Elevation of serum cholesterol requiring dietary or drug treatment. Use field 2.15 (Serum cholesterol) for present value of cholesterol. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.09 | Peripheral vascular disease |  |  | The presence of peripheral vascular disease, either presently symptomatic or previously treated by intervention or surgery. Include known renovascular disease and aortic aneurysm. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.10 | Cerebrovascular disease |  |  | A history of cerebrovascular ischaemia. To include transient cerebral ischaemic episodes as well as events with deficit lasting >24 hours. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.11 | Asthma or COPD |  |  | Any form of obstructive airways disease. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.12 | Chronic renal failure |  |  | Creatinine chronically >200 micromol/L. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.13 | Heart failure |  |  | A previously validated diagnosis of heart failure on any therapeutic regime. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.14 | Cardiac markers raised? |  |  | Identifies if cardiac biomarkers are raised during the acute phase of this admission. The local reference limit should be confirmed with your clinical chemistry department. | Code n1 | N
 |  | 0 | No | An absence of any rise in cardiac bio-markers (usually troponin) to a value above the 99th centile of the upper reference limit for the assay used.
 |  | 1 | Yes | A rise in cardiac bio-markers (usually troponin) with at least one value above the 99th centile of the upper reference limit for the assay used.
 |  | 9 | Unknown | If the patient dies before bloods are taken enter Unknown.
2.15 | Serum cholesterol |  |  | A sample taken within 24 hours of admission. | n2.1 | N
2.16 | Smoking status |  |  |  | Code n1 | N
 |  | 0 | Never smoked | Patient has never smoked.
 |  | 1 | Ex smoker | An ex smoker is one who has given up smoking more than one month previously.
 |  | 2 | Current smoker | A current smoker is a patient regularly smoking an average of 1 or more cigarettes per day, or equivalent. Any cigarettes smoked in the last month classify the patient as a current smoker.
 |  | 3 | Non smoker - smoking history unknown | Currently a non smoker but past history unknown.
 |  | 9 | Unknown | Smoking status unknown.
2.17 | Diabetes |  |  |  | Code n1 | N
 |  | 0 | Not diabetic | Not known diabetic.
 |  | 1 | Diabetes (dietary control) | Diabetic not receiving insulin or oral medication.
 |  | 2 | Diabetes (oral medicine) | Diabetic receiving oral medication prior to admission.
 |  | 3 | Diabetes (insulin) | Diabetic receiving insulin without additional oral medication.
 |  | 5 | Insulin plus oral medication | Diabetic receiving insulin and oral medication prior to admission.
 |  | 9 | Unknown
2.18 | Previous PCI |  |  | A percutaneous coronary intervention at any time prior to this admission. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.19 | Previous CABG |  |  | Coronary artery bypass grafting at any time prior to this admission. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.20 | Systolic BP |  |  | The first systolic blood pressure recorded after admission to hospital. The patient should be in a stable cardiac rhythm, ie sinus or chronic AF.  Where the presenting rhythm is a treatable tachyarrhythmia, the first stable SBP after treatment should be used. | n3 | N
2.21 | Heart rate |  |  | The heart rate recorded from the first ECG after admission to hospital, whilst in a stable cardiac rhythm ie sinus rhythm, or chronic AF. In complete heart block record ventricular rate.  Where the presenting rhythm is a treatable tachyarrhythmia, the first stable heart rate after treatment should be used. | n3 | N
2.22 | Admitting consultant |  |  | The clinician having primary care of the patient immediately (first 24 hours) after admission to hospital (not the A&E consultant). | Code n2 | N
 |  | 0 | Cardiologist | Cardiologist or physician with a major interest in cardiology.
 |  | 1 | Other general physician | All other physicians.
 |  | 9 | Other | Patient admitted under another discipline, e.g. surgeon.
 |  | 99 | Unknown
2.23 | Place first 12 lead ECG performed |  |  | This refers to the 1st ECG recorded, not necessarily the diagnostic ECG. | n1 | N
 |  | 1 | Ambulance | An ECG performed in any location by ambulance paramedic staff as a result of an emergency call.
 |  | 2 | In hospital | In this hospital.
 |  | 3 | Other healthcare facility | Includes general practice or care home where the ECG was performed by a non paramedic.
 |  | 9 | Unknown
2.24 | Beta blocker use |  |  | Any beta blocker in regular use prior to this admission. | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.25 | ACEI or ARB use |  |  | Any angiotensin converting enzyme inhibitor or angiotensin receptor blocking agent in regular use prior to this admission. | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.26 | Statin use |  |  | Any statin in regular use prior to this admission. | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.28 | Serum glucose |  |  | Glucose taken on admission (not necessarily fasting). | n2.1 | N
2.29 | Height |  |  | Height in cms to derive BMI. | n3 | N
2.30 | Weight |  |  | Weight in kgs to derive BMI. | n3.1 | N
2.31 | Left ventricular ejection fraction |  |  | Left ventricular ejection fraction measured during this admission by echo, angio, radionuclide or MR study. | n1 | N
 |  | 1 | Good | >=50%
 |  | 2 | Moderate | 30-49%
 |  | 3 | Poor | <30%
 |  | 8 | Not assessed
 |  | 9 | Unknown
2.32 | Family history of CHD |  |  | Identifies a family history of premature CHD by diagnosis, (males before 55, females before 65). | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.33 | Cardiological care during admission |  |  | Record if the patient was seen by a cardiologist (or member of clinical team working under the supervision of a consultant cardiologist) during admission. | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.34 | Creatinine |  |  | Recorded within 24 hours of admission, (micromol/L). | n 4 | N
2.35 | Haemoglobin |  |  | Recorded within 24 hours of admission; expected range would be 50-250 (g/L) | n 3.1 | N
2.36 | Site of infarction |  |  | Enter the area having the most extensive ST segment changes. | n1 | N
 |  | 1 | Anterior
 |  | 2 | Inferior
 |  | 3 | Posterior
 |  | 4 | Lateral
 |  | 5 | Indeterminate | Use in presence of very extensive changes.
 |  | 9 | Unknown
2.37 | ECG QRS complex duration |  |  | Must be stable feature on ECGs during admission. NICE MI secondary prevention audit criteria. | n1 | N
 |  | 1 | QRS complex duration >= 120 msec | Persistent not transient prolongation.
 |  | 2 | QRS complex duration <120 msec
 |  | 9 | Unknown
2.38 | Thienopyridine inhibitor use |  |  | Use of any thienopyridine inhibitor (includes Clopidogrel and Prasugrel) prior to this admission. | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
2.39 | Admission method |  |  |  | n1 | N
 |  | 1 | Direct admission via emergency service | Implies arrival by ambulance, helicopter.
 |  | 2 | Self presenter to this hospital | Implies that the patient made their own way (public transport, brought by relative etc,.) to hospital.  Includes those advised to do so by GP.
 |  | 3 | Already in this hospital | If the patient is already in hospital with another diagnosis it is only necessary to enter the date of symptom onset and the date of arrival at hospital.  Use if patient is admitted from a Rapid Access Chest Pain Clinic.
 |  | 4 | Inter-hospital transfer for specific treatment | Specifically covers transfer to specialist centre for proposed treatment (other than 5).
 |  | 5 | Repatriation after coronary intervention | Return from interventional centre (usually after pPCI)
 |  | 6 | Other
 |  | 9 | Unknown
2.4 | Patient location at time of STEMI |  |  | The purpose of this field is to permit identification of STE MI not originating in the community, in order that such patients can be excluded, where appropriate, from call to needle and call to balloon analyses. | n1 | N
 |  | 1 | Onset of STEMI while patient not in hospital (STE on first ECG) | This implies that ST elevation was found on first ECG performed in an ambulance or other medical facility (GP surgery etc) before arrival at the first hospital or on the first ECG recorded in hospital for a self presenter.  If no ECG was taken prior to arrival at the first hospital (whether admitted or not) and first ECG recorded in hospital  shows ST elevation then it should be assumed that STEMI  developed before reaching hospital. This option should also be selected where an ECG was not considered diagnostic before admission, but STE is diagnosed on arrival at A&E.
 |  | 2 | STE first recorded on a subsequent ECG in, (or before arrival at) a non-interventional hospital | The word subsequent applies to any ECG taken after an initial non-diagnostic ECG was performed in the ambulance or at the non-interventional hospital.  This group of patients will have arrived in hospital without a diagnosis of STE MI, and then develop ST segment elevation after hospital arrival (whether admitted or not). The subsequent ECG may be at any time after admission to hospital.  This option covers a spectrum from patients initially presenting with features consistent with ACS who go on to develop STEMI through to patients who are admitted for some other condition who develop STEMI while in hospital.
 |  | 3 | STE first recorded on a subsequent ECG in, (or before arrival at) the interventional hospital | The word subsequent applies to any ECG taken after an initial non-diagnostic ECG was performed in the ambulance or at the interventional hospital.  This group of patients will have arrived in hospital without a diagnosis of STE MI, and then develop ST segment elevation after hospital arrival (whether admitted or not). The subsequent ECG may be at any time after admission to hospital.  This option covers a spectrum from patients initially presenting with features consistent with ACS who go on to develop STEMI through to patients who are admitted for some other condition who develop STEMI while in hospital.
 |  | 8 | Not applicable
 |  | 9 | Unknown
2.41 | [NAME] class |  |  | A part of the GRACE score.  The worst category developing during the admission should be used. | n1 | N
 |  | 1 | No evidence of heart failure
 |  | 2 | Basal crepitations and/or elevated venous pressure
 |  | 3 | [NAME] oedema | Extensive lung crepitations consistent with pulmonary oedema, or confirmatory X ray evidence.
 |  | 4 | Cardiogenic shock | Hypotension, poor tissue perfusion and oliguria due to venticular dysfunction in the presence of raised filling pressures.
 |  | 8 | Not applicable | Where patient dies or is transferred early in the event.
 |  | 9 | Unknown
2.42 | Stress echo |  |  | As per NICE guideline | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 2 | Planned after discharge | Only use this option when firm arrangements are in place before discharge.
 |  | 8 | Not indicated
 |  | 9 | Unknown
3.01 | Date/time of symptom onset |  |  | Valid date>1/1/2000 and <=Today. The time to within 10 minutes, if possible, when symptoms began. Where there is a prodrome of intermittent pain the time recorded should be the time of onset of those symptoms which led the patient to call for help.  Where admission followed an out of hospital cardiac arrest, with no better information available, use the time of the arrest for onset of symptoms. | DateTime | N
3.02 | Date/time of call for help |  |  | Valid date>1/1/2000 and <=Today. The time of the initial call by patient, relative or attendant. This may be to a GP, NHS Direct, or the ambulance service. If 999 call use call connect time, the time the emergency call is connected to local ambulance control. The call connect time should be taken from the ambulance CAD form. If the call was to a GP (or deputising service), or NHS Direct you will have to establish this time as accurately as possible from the patient. | DateTime | N
3.03 | Date/time of arrival of first responder |  |  | Valid date>1/1/2000 and <=Today. Time of arrival of general practitioner or other first responder. Includes community first responder or paramedic in car. | DateTime | N
3.04 | Date/time of arrival of ambulance |  |  | Valid date>1/1/2000 and <=Today. Arrival of ambulance capable of transporting patient. Should be available on the ambulance PRF form. | DateTime | N
3.05 | Ambulance Job Number |  |  | This should be in the form of 3 letter ambulance trust code, followed by the by the CAD or Incident number (or the PRF number if the CAD number not available), followed by the date of admission in the format ddmmyyyy, without any spaces. | Id an? | N
3.06 | Date/time arrival at hospital |  |  | This field MUST be completed - all patients must have an admission date and time. This refers to your hospital. Please use the time recorded by the ambulance service, not the time of the first ECG, nor the time of registration in A&E. Use A&E registration time if patient self presented in A&E or time of ambulance arrival at hospital if a  direct admission. Even if precise times are unknown, and the patient does not receive reperfusion treatment, you MUST enter the date of admission to hospital. Time of arrival in hospital is the time of arrival of the ambulance at the front door. For interventional centres is Date/time of arrival at interventional centre. Where transferred for primary PCI use 3.46 for date/time of arrival at non interventional hospital. | DateTime | N
3.08 | Reason reperfusion treatment not given |  |  | Reperfusion treatment refers to primary PCI and thrombolytic treatment and applies only to patients with ST elevation infarction. Where there is more than one contraindication to treatment you can only enter one option, with 'Too late' having priority over all the others. | n2 | N
 |  | 0 |  | This is default value which should be changed to the appropriate option.
 |  | 1 | Ineligible ECG | No ECGs show unequivocal ST elevation or LBBB - NB: this choice is NOT compatible with an initial diagnosis of Definite MI because that diagnosis implies that the ECG must have been diagnostic of ST elevation infarction.
 |  | 2 | Too late | A decision made in light of a local protocol. It may be checked against other recorded delays where initial diagnosis is definite myocardial infarction.
 |  | 3 | Risk of haemorrhage | Includes risk of bleeding from all sites and after prolonged resuscitation.
 |  | 4 | Uncontrolled hypertension | An appropriate contraindication especially in older people.
 |  | 5 | Administrative failure | To be used where in the opinion of a senior clinician reperfusion treatment was withheld incorrectly.
 |  | 6 | Elective decision | To be used where a decision was made not to treat a patient (severe coexisting morbidity, or dying).
 |  | 7 | Patient refused treatment
 |  | 8 | Other | Use for any contraindication not covered by other options.
 |  | 9 | Unknown | Use when eligible patient fails to receive reperfusion treatment without a stated reason.
3.09 | Date/time of reperfusion treatment |  |  | The time of onset of lytic treatment, whether infusion or injection. The time the first device is used in coronary artery (balloon, stent or extraction catheter). It is not the time the angioplasty guidewire is first introduced, even if this restores flow. | DateTime | N
3.10 | Delay before treatment |  |  | Delay before treatment can occur at any time from the moment of arrival of the ambulance crew. Where it is policy for prehospital treatment to be given, any of the reasons for delay can be used by the paramedic crew. Applies to all forms of reperfusion treatment. | Code n2 | N
 |  | 0 | No | There was no operational delay regardless of the time to treatment.
 |  | 1 | Sustained hypertension | As defined by local protocol.
 |  | 2 | Clinical concern about recent cerebrovascular event or surgery | Where delay results from need to check on significance of recent cerebrovascular event or operative procedure.
 |  | 3 | Delay obtaining consent | Where patient requests delay. Use only when the patient wishes to take time to consider treatment options.
 |  | 4 | Initial ECG ineligible | Where, after an initially ineligible ECG, reperfusion treatment is used after development of ST elevation. These patients are not included in DTN and CTN analyses.
 |  | 5 | Cardiac arrest | Cardiac arrest includes an arrest occurring before arrival in hospital.
 |  | 6 | Obtaining consent for therapeutic trial | Consent for a therapeutic trial. Use only for an approved study.
 |  | 7 | Hospital administrative failure | Includes any valid procedural reason why treatment was delayed in hospital. This would include instances of misdiagnosis/misinterpretations of ECG.
 |  | 8 | Ambulance procedural delay | This includes any pre-hospital delay outside the control of the ambulance service, eg incorrect address, difficulty finding address, unable to gain entry to patient’s house, patient reasons eg initial refusal to go to hospital or extended domestic arrangements, adverse weather conditions, stabilising the patient, crew had to wait for boat, helicopter delay, wait for police to gain entry, failure to cannulate.
 |  | 9 | Other | Use for any delay not covered by other options.
 |  | 10 | Ambulance 12 lead ECG not diagnostic of STEMI | When initial ambulance 12 lead ECG is non diagnostic of STEMI.
 |  | 11 | Consideration of primary PCI | Where consideration for primary PCI led to a delay in providing thrombolysis.
 |  | 12 | Ambulance administrative delay | When initial ambulance 12 lead ECG is diagnostic of STEMI but patient outwith local criteria for paramedic thrombolysis.
 |  | 13 | Cath lab access delayed
 |  | 14 | Delay in activating cath lab team
 |  | 15 | Pre-PCI complication | Includes cardiogenic shock and insertion of IABP and ventilation.
 |  | 16 | Equipment failure
 |  | 17 | Convalescent STEMI | Acute coronary syndrome with or without enzyme release and a history typical of acute myocardial infarction. Patients whose initial presentation was STEMI, but whose PCI is being performed later during the hospital stay are included in this group. (Excludes patients having PCI in the throws of an ongoing STEMI.
3.11 | Where was initial reperfusion treatment given? |  |  |  | Code n1 | N
 |  | 0 | No reperfusion attempted
 |  | 1 | Before admission to hospital | Treatment before reaching hospital regardless of who initiated treatment.
 |  | 2 | In A&E | Regardless of who initiated treatment there.
 |  | 3 | In CCU (direct admission) | A patient who enters CCU directly from an ambulance without assessment by hospital clinical staff before arrival.
 |  | 4 | In CCU (slowtrack) | Implies admission via A&E or other assessment unit  where a diagnosis of definite infarction was made, followed by transfer to CCU where thrombolytic treatment was initiated.
 |  | 5 | Elsewhere in hospital | Includes acute admission units, general medical wards and catheter laboratories.
 |  | 6 | Cath lab
 |  | 9 | Unknown
3.13 | Cardiac arrest date/time - FIRST ARREST ONLY |  |  | Date and time of FIRST verified arrest only to be reported. Excludes syncope or profound vagally-mediated bradycardia. Enter date and time of death if resuscitation not attempted. | DateTime | N
3.14 | Cardiac arrest location |  |  |  | Code n1 | N
 |  | 1 | No arrest | Provides confirmation that patient did not have an arrest. The default option.
 |  | 2 | Before ambulance arrival | Implies arrest did not take place in presence of a trained medic/paramedic (specifically called to the scene) and including trained first responders deployed by the ambulance services.
 |  | 3 | After ambulance arrival | Implies arrest in the presence of a medic/paramedic.
 |  | 4 | A&E
 |  | 5 | CCU
 |  | 6 | Medical ward
 |  | 7 | Elsewhere in hospital | Refers to OPD, X-ray, etc.
 |  | 8 | Catheter lab
3.15 | Arrest presenting rhythm |  |  |  | Code n1 | N
 |  | 1 | Asystole
 |  | 2 | VF/pulseless VT | Also includes any other haemodynamically catastrophic tachyarrhythmia.
 |  | 3 | EMD | Also referred to as pulseless electrical activity.
 |  | 9 | Unknown
3.16 | Outcome of arrest |  |  | Applies only to outcome of the first arrest. This should include arrests in which resuscitation was deemed to be inappropriate. Please enter the fact that resuscitation was not attempted for whatever reason (such as severe co-morbidity). If further arrests occur the outcome will be recorded in the field ‘Death in hospital'. | Code n1 | N
 |  | 1 | No return of circulation | Failed resuscitation.
 |  | 2 | Return of spontaneous circulation but died in hospital | Return of a stable circulation with subsequent death in hospital.
 |  | 3 | Discharged from hospital (with neurological deficit)
 |  | 4 | Discharged from hospital (no neurological deficit)
 |  | 5 | Resuscitation not attempted | This will be an decision normally made in advance of the arrest.
 |  | 6 | Transferred to another hospital
 |  | 9 | Unknown
3.17 | Admission ward |  |  | The purpose of this question is to determine where immediate care took place. Refers to the unit to which the patient is admitted either from A&E or directly by ambulance service and where patient will spend majority of first 24 hours in hospital. If patient admitted direct to cath lab, enter facility to which patient admitted on leaving lab. | Code n1 | N
 |  | 1 | Cardiac care unit | A unit providing level 2 facilities. This may be a cardiac care facility shared with ITU or HDU, or might be part of a cardiac ward or general ward, but providing a higher level of monitoring and cardiac nursing numbers and expertise.
 |  | 2 | Acute admissions unit | A unit for the assessment of non-specific acute medical admissions.
 |  | 3 | General medical ward | A medical ward without fixed monitoring facilities or additional cardiac nursing expertise.
 |  | 4 | Intensive therapy unit | Where this is separate from a CCU, and is not the usual place of care for early infarction (post-arrest or when CCU is full, etc).
 |  | 5 | Other | To record patients admitted to non-medical wards or who had infarction while already in hospital.
 |  | 6 | Died in A&E | Very important for interpretation of mortality data.
 |  | 7 | Cardiac ward (non CCU) | A cardiac ward, having staff with specific cardiac nursing expertise, but without necessarily higher numbers of staff / patient or central monitoring facilities.
 |  | 8 | Stepdown ward | A facility normally used primarily for patients after initial care on CCU.
 |  | 9 | Unknown
3.19 | Peak Troponin |  |  | This field allows to record any value, whether with decimal places or an integer, BUT remember to record the type of assay used (field 3.37). | n4.2  [2 places of decimals please] | N
3.20 | Unfractionated heparin |  |  | Use of unfractionated heparin as therapy for ACS or STEMI either alone or in conjunction with other treatment. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if used therapeutically while in hospital.
 |  | 9 | Unknown
3.21 | Low molecular weight heparin |  |  | As for unfractionated heparin. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if used therapeutically while in hospital.
 |  | 9 | Unknown
3.22 | Thienopyridine platelet inhibitor |  |  | eg Clopidogrel, Prasugrel | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if on treatment at admission and drug continued or introduced while in hospital.
 |  | 9 | Unknown
3.24 | IV 2b/3a agent |  |  | Excludes use of 2b/3a agents started during PCI. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if used therapeutically while in hospital.
 |  | 9 | Unknown
3.25 | IV beta blocker |  |  |  | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if used therapeutically while in hospital.
 |  | 9 | Unknown
3.27 | Calcium channel blocker |  |  |  | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if on treatment at admission and drug continued or introduced while in hospital.
 |  | 9 | Unknown
3.28 | IV nitrate |  |  |  | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if used therapeutically while in hospital.
 |  | 9 | Unknown
3.29 | Oral nitrate |  |  | Does not include sublingual nitroglycerine or spray in use on admission and continued or introduced in hospital on an as-needed basis. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if on treatment at admission and drug continued or introduced while in hospital.
 |  | 9 | Unknown
3.30 | Potassium channel modulator |  |  |  | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if on treatment at admission and drug continued or introduced while in hospital.
 |  | 9 | Unknown
3.31 | Warfarin |  |  |  | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if on treatment at admission and drug continued or introduced while in hospital.
 |  | 9 | Unknown
3.32 | [NAME] converting enzyme inhibitor or angiotensin receptor blocker (ARB) |  |  |  | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if on treatment at admission and drug continued or introduced while in hospital.
 |  | 9 | Unknown
3.33 | Thiazide diuretic |  |  |  | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if on treatment at admission and drug continued or introduced while in hospital.
 |  | 9 | Unknown
3.34 | Loop diuretic |  |  |  | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record yes if on treatment at admission and drug continued or introduced while in hospital.
 |  | 9 | Unknown
3.36 | Thrombolytic drug |  |  | The agent used for first thrombolytic treatment. | Code n1 | N
 |  | 1 | Streptokinase
 |  | 2 | Alteplase
 |  | 3 | Reteplase
 |  | 4 | Tenecteplase
3.37 | Troponin assay |  |  | Troponin assay used. | Code n1 | N
 |  | 1 | Troponin I
 |  | 2 | Troponin T
 |  | 3 | High sensitivity Troponin T
 |  | 4 | High sensitivity troponin I
 |  | 9 | Unknown
3.38 | Fondaparinux |  |  | Record if used while in hospital. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
3.39 | Initial reperfusion treatment |  |  | This refers to treatment given in your hospital. | Code n1 | N
 |  | 0 | None
 |  | 1 | Thrombolytic treatment
 |  | 2 | pPCI in house | Primary PCI for STE MI. Includes patients presenting with a clear history of AMI and LBBB.
 |  | 3 | Referred for consideration for pPCI elsewhere | Intended primary PCI for STEMI/LBBB.  At the time of referral (or data entry) the reperfusion treatment actually performed may not be known. These cases will subsequently be linked with the interventional hospital record. |  |  |  |  | Code n1 | N
 |  | 4 | pPCI already was peformed at the interventional hospital | This is for use by non-interventional hospitals only. Use this option when a patient comes to you for the first time following primary PCI elsewhere.
 |  | 9 | Unknown
3.40 | Additional reperfusion treatment |  |  | Further emergency reperfusion treatment where initial treatment may have failed. | Code n1 | N
 |  | 0
 |  | 1 | Rescue PCI in house | Emergency PCI for acute STEMI for failed thrombolysis - commonly performed for failure of ST segment resolution or continuing ischaemic symptoms following lytic treatment. Performed in this hospital for either patients admitted directly or transferred from another hospital.
 |  | 2 | Referred for rescue PCI elsewhere | Intended rescue PCI.  At the time of referral (or data entry) the treatment performed may not be known.
 |  | 3 | Facilitated PCI | Elective PCI performed in the acute setting following lytic treatment for STEMI (or new LBBB).
 |  | 4 | Additional dose of thrombolytic | Use where a second thrombolytic is given for perceived failure of reperfusion. Do not use when another lytic is substituted for streptokinase because of adverse effects occurring during SK infusion.
3.41 | In patient management of hyperglycaemia/diabetes |  |  | Treatment given during the first 24 hours (or longer), even if this regime is subsequently changed. Each insulin regime may be in combination with oral therapy. Diabetic treatment should be recorded regardless of whether the patient is known to be diabetic or presents for the first time with hyperglycaemia. | Code n1 | N
 |  | 0 |  | No pharmacological diabetic treatment (either oral or by injection) was given during the admission. See option 7.
 |  | 1 | Glucose insulin regime | Insulin by pump with additional IV glucose according to local protocol.
 |  | 2 | Insulin pump | Insulin by pump.
 |  | 3 | Multi dose insulin | 3 or more individual doses of subcutaneous insulin / 24 hours, either as regular doses or sliding scale insulin. This may be a continuation of the preadmission regime where 3 or more doses / day was used.
 |  | 4 | Other pre-admission insulin regime | Insulin regime of 2 or less doses per 24 hours.
 |  | 5 | Oral medication only | Any form of oral medication without any insulin.
 |  | 7 | Diet only | For known diabetics continuing (low carbohydrate) diet without additional medication.
 |  | 9 | Unknown
3.42 | Diabetic therapy at discharge |  |  | Oral therapy may be given in combination with insulin. | Code n1 | N
 |  | 0
 |  | 1 | Multi dose insulin regime | Insulin given three or more times daily.
 |  | 2 | Other insulin regime | Insulin less than three times daily.
 |  | 3 | Oral medication | Any oral medication used without insulin.
 |  | 4 | Insulin plus oral medication
 |  | 5 | Diet only | A low carbohydrate diet for diabetes.
 |  | 6 | Not applicable | For patients who die or are transferred to another hospital
 |  | 9 | Unknown
3.43 | Oral beta blocker |  |  | In hospital use. | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
3.44 | Aldosterone antagonist |  |  | In hospital use, includes Eplerenone and Spironolactone. | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
3.45 | Bivalirudin |  |  | [NAME] as therapy for ACS or STEMI either alone or in conjunction with other treatment. | n1 | N
 |  | 0 | No
 |  | 1 | Yes | Record 1. yes if used therapeutically in hospital
 |  | 2 | Contraindicated
 |  | 8 | Not indicated
 |  | 9 | Unknown
3.46 | Date/time of arrival at non interventional hospital |  |  | Date and time of arrival of ambulance at non interventional hospital. Date and time of arrival (when the wheels stop turning) at non interventional hospital. Where a hospital does not provide 24/7 intervention it is a non interventional hospital outside of these hours. | Date/ time | N
3.47 | Assessment at non interventional hospital |  |  | Place of assessment after arrival at non interventional hospital. | Text | N
 |  | 0 | No contact with a non interventional hospital | Where a hospital provides a less than 24/7 interventional service, it should be categorised into interventional / non-interventional depending on whether the lab is open at the time of presentation.
 |  | 1 | Patient remains in ambulance | Ambulance parked in hospital grounds in order to facilitate assessment by a member of hospital staff.
 |  | 2 | A&E | Patient is moved into A&E for assessment.
 |  | 3 | Acute assessment unit | Other non cardiac specific ward.
 |  | 4 | CCU / cardiac facility | Cardiac facility. Any area with specialised nursing staff.
 |  | 5 | Self referral | Patient made own way to non interventional hospital.
 |  | 6 | Already in hospital | Admitted prior to this event. Eg., already in hospital with ACS, and develops new symptoms with ST elevation. Or, after admission with ACS, transferred for intervention as part of routine care for ACS.
 |  | 7 | Other
 |  | 9 | Unknown
3.48 | Assessment at interventional centre |  |  | Place of assessment after arrival at interventional centre. | Text | N
 |  | 1 | Assessed in A&E | Self presenters might be assessed here.
 |  | 2 | Acute assessment unit | A non specific area for assessment of acute admissions.
 |  | 3 | CCU / cardiac facility | Facility with specialised nursing staff.
 |  | 4 | Catheter laboratory | Including areas immediately adjacent.
 |  | 5 | Already in hospital | Already in interventional hospital.
 |  | 9 | Unknown
3.49 | Intended reperfusion procedure |  |  | Intended reperfusion treatment after assessment at interventional centre. | Text | N
 |  | 0
 |  | 1 | Primary PCI
 |  | 2 | Rescue PCI | A procedure for continuing symptoms / features of non reperfusion for STEMI.
 |  | 3 | Thrombolytic treatment | Note. If intended reperfusion treatment was with lytic drug - which was not given - use MINAP 3.08 to explain why. If lysis used, existing MINAP fields will cover.
 |  | 4 | Other coronary intervention | Covers all interventions other than for acute management of STEMI, eg elective intervention for STEMI / nSTEMI or for new symptoms.
 |  | 9 | Unknown
3.5 | Procedure performed |  |  | Intended treatment may not necessarily occur; lab may be unavailable, etc,. | Text | N
 |  | 1 | No angiogram
 |  | 2 | Angiogram but no PCI
 |  | 3 | Angiogram and PCI
 |  | 9 | Unknown
3.51 | Why was no angiogram performed? |  |  |  | Text | N
 |  | 0 | Not applicable | Where angiography has been performed.
 |  | 1 | Diagnosis not ACS | Another diagnosis - not an acute coronary syndrome -  was established.
 |  | 2 | Patient refused
 |  | 3 | Patient died
 |  | 4 | Complication before angio could be performed | An acute medical event resulting in cancellation of a planned angiogram / intervention.
 |  | 5 | Angio inappropriate due to co-morbidity | Patient co-morbidity made angio inappropriate. For use where there is advanced malignancy, dementia, progressive neurological disease or other conditions having an immediate impact on prognosis. Includes other clinical reasons identified by the clinician.
 |  | 6 | Technical failure | Any operator related failure, including failure of arterial access.
 |  | 7 | Lab unavailable | Access to lab not possible at a time when lab normally available.
 |  | 8 | Other | Including absent staff or equipment problems.
 |  | 9 | Unknown
3.52 | Why was no intervention performed? |  |  |  | Text | N
 |  | 0 | Not applicable | Where pPCI or other coronary intervention has been performed.
 |  | 1 | Patient refused | Patient refused intervention after angio.
 |  | 2 | Patient died | Patient dies after angio.
 |  | 3 | Complication before PCI could be performed | An acute medical event preventing intended procedure from starting.
 |  | 4 | PCI felt to be inappropriate | eg Because of co-morbidity, eg., acute VSD, cardiac rupture; acute MR; coronary spasm, spontaneous dissection; thrombus treated with drug therapy (e.g. [NAME] and heparin), etc
 |  | 5 | Angiographically normal coronaries / mild disease / Infarct Related Vessel unclear
 |  | 6 | Surgical disease
 |  | 7 | Technical failure | Any technical / operator failure after starting interventional procedure, including no arterial access.
 |  | 8 | Other
 |  | 9 | Unknown
3.53 | Date/time of start of insulin infusion |  |  | The time of start of any insulin infusion. | Date/time | N
4.01 | Date of discharge |  |  | Includes date of transfer to another hospital  (but not as a day case), and date of death. | Date | N
4.02 | Discharge diagnosis |  |  | The biochemical 'definition' of infarction remains imprecise because of the variations in assay performance. Until a standardised assay becomes available it is recommended that these definitions are used. | Code n1 | N
 |  | 1 | Myocardial infarction (ST elevation) | There will normally be a history consistent with the diagnosis. The diagnosis requires the presence of cardiographic changes of ST elevation consistent with infarction of =>2mm in contiguous chest leads and/or ST elevation of =>1 mm ST elevation in 2 or more standard leads. (New LBBB is included; although ST elevation is usually apparent in the presence of LBBB). There must be enzyme or troponin elevation. Where CK is used the peak value should exceed twice the upper limit of the reference range. Where troponin assay is used the locally accepted cut off value should be used. (See Threatened MI) This group includes all patients with STEMI regardless of whether typical changes were evident on the admission ECG or developed subsequently.
 |  | 3 | Threatened MI | After early reperfusion treatment there may be rapid resolution of existing ST elevation associated with a CK rise less than twice the upper limit of normal or a small troponin release. If only troponin has been measured and is elevated; it is a local decision whether this is recorded as 'Definite infarction' or 'Threatened infarction'.
 |  | 4 | Acute coronary syndrome (troponin positive)/ nSTEMI | ACS troponin positive includes all those patients previously defined as nSTEMI. There must be symptoms consistent with cardiac ischaemia and there will normally be cardiographic changes consistent with this diagnosis. Troponon elevation above locally determined reference level is mandatory.
 |  | 5 | Acute coronary syndrome (troponin negative) | Use where there are symptoms consistent with cardiac ischaemia without troponin release. There must be dynamic ECG changes consistent with fluctuating ischaemia. Synonym unstable angina.
 |  | 6 | Chest pain of uncertain cause | Use in any patient admitted with chest pain not accompanied by significant cardiographic change, without any enzyme / troponin release, and where no other clear diagnosis emerges.  It is likely that at admission there was a high index of clinical suspicion that the pain was cardiac, but this remains unconfirmed.
 |  | 7 | Myocardial infarction (unconfirmed) | This diagnosis must only be applied to patients who die in hospital before biochemical confirmation of infarction can be confirmed.
 |  | 8 | Other diagnosis | Use where a patient is admitted with clinical suspicion of cardiac pain and where any diagnosis other than cardiac ischaemia is confirmed.
 |  | 9 | Takotsubo Cardiomyopathy | Essential criteria: 1) left [NAME] motion abnormalities, usually apical and midventricular, extending beyond a single coronary artery territory, and 2) absence of obstructive/culprit coronary disease, and 3) ST or T wave abnormalities on the ECG.                                                                                      Non-essential criteria: 4) Dynamic prolongation of the QTc interval, 5) Cardiac enzyme rise, 6) Natriuretic peptide rise, 7) Stressful precipitant
 |  | 11 | PCI related MI | Percutaneous coronary intervention (PCI) related MI is arbitrarily defined by elevation of cTn values (>5 x 99th percentile URL) in patients with normal baseline values (≤99th percentile URL) or a rise of cTn values >20% if the baseline values are elevated and are stable or falling. In addition, either (i) symptoms suggestive of myocardial ischaemia or (ii) new ischaemic ECG changes or (iii) angiographic findings consistent with a procedural complication or (iv) imaging demonstration of new loss of viable myocardium or new regional wall motion abnormality are required.
4.03 | Bleeding complications |  |  | This should be used for bleeding following any therapeutic intervention, whether drug (including pre-hospital thrombolysis) or primary PCI (including sheath removal) but not including bleeding complications following repeat angiography/intervention. Use should be limited to bleeding occurring within 24 hours of the finish of any therapeutic intervention. Options are given in order of precedence: use the first option that applies. | Code n1 | N
 |  | 0
 |  | 1 | Intracranial bleed | Of any severity. Should ideally be confirmed  by scanning.
 |  | 2 | Retroperitoneal haemorrhage | Of any severity. Should ideally be confirmed  by scanning.
 |  | 3 | Any bleed with Hb fall > 50g | From any site except options 1 and 2.
 |  | 4 | Any bleed with Hb fall > 30g and < 50g
 |  | 5 | Any bleed with Hb fall <30 g
 |  | 9 | Unknown
4.04 | Death in hospital |  |  |  | Code n1 | N
 |  | 0 | No
 |  | 1 | From MI | From all causes attributable to index event; whether due to VF, or cardiogenic shock.
 |  | 2 | From complication of treatment | Death from haemorrhagic stroke or other bleed as a result of treatment.
 |  | 3 | Other non cardiac related cause
 |  | 4 | Other cardiac cause | Death due to heart failure, or arrhythmia etc, where there was NO acute coronary event leading to this admission, or occurring during the admission but where the patient had been logged in MINAP.
 |  | 9 | Unknown
4.05 | Discharged on beta blocker |  |  | Discharged from hospital on oral beta adrenergic blocker treatment. Patients transferred are not included in analysis of use of secondary prevention drugs. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Use 1.Yes if patient was on the drug at admission and treatment was continued while in hospital.
 |  | 2 | Contraindicated
 |  | 3 | Patient declined treatment
 |  | 4 | Not applicable | For patients who die or are transferred to another hospital.
 |  | 8 | Not indicated
 |  | 9 | Unknown
4.06 | Discharged on angiotensin converting enzyme inhibitor or angiotensin receptor blocker |  |  | Discharged from hospital on angiotensin converting enzyme inhibitor or angiotensin receptor blocker. Patients transferred are not included in analysis of use of secondary prevention drugs. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Use 1.Yes if patient was on the drug at admission and treatment was continued while in hospital.
 |  | 2 | Contraindicated
 |  | 3 | Patient declined treatment
 |  | 4 | Not applicable | For patients who die or are transferred to another hospital.
 |  | 8 | Not indicated
 |  | 9 | Unknown
4.07 | Discharged on statin |  |  | Discharged from hospital on a statin. Patients transferred are not included in analysis of use of secondary prevention drugs. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Use 1.Yes if patient was on the drug at admission and treatment was continued while in hospital.
 |  | 2 | Contraindicated
 |  | 3 | Patient declined treatment
 |  | 4 | Not applicable | For patients who die or are transferred to another hospital.
 |  | 8 | Not indicated
 |  | 9 | Unknown
4.08 | Discharged on aspirin |  |  | Discharged from hospital taking aspirin. Patients transferred are not included in analysis of use of secondary prevention drugs. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes | Use 1.Yes if patient was on the drug at admission and treatment was continued while in hospital.
 |  | 2 | Contraindicated
 |  | 3 | Patient declined treatment
 |  | 4 | Not applicable | For patients who die or are transferred to another hospital.
 |  | 8 | Not indicated
 |  | 9 | Unknown
4.09 | Cardiac rehabilitation |  |  | Refers specifically to further rehabilitation arranged after discharge (as rehabilitation in the sense of lifestyle advice will already have been given). | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 3 | Patient declined
 |  | 8 | Not indicated | Further rehabilitation may not be indicated because of severe comorbidity etc.
 |  | 9 | Unknown
4.10 | Exercise test |  |  | Performance of an exercise test during this admission. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 2 | Planned after discharge | Only use this option when firm arrangements are in place before discharge.
 |  | 8 | Not indicated
 |  | 9 | Unknown
4.11 | Echocardiography |  |  | Performance of an echocardiograph during this admission. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 2 | Planned after discharge | Only use this option when firm arrangements are in place before discharge.
 |  | 8 | Not indicated
 |  | 9 | Unknown
4.12 | Radionuclide study |  |  | Performed at this admission. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 2 | Planned after discharge | Only use this option when firm arrangements are in place before discharge.
 |  | 8 | Not indicated
 |  | 9 | Unknown
4.13 | Coronary angiography |  |  | Coronary angiography performed or arranged, but not as part of the initial reperfusion strategy. | Code n1 | N
 |  | 1 | Protocol driven investigation performed in this hospital | Angiography indicated on basis of risk factors.
 |  | 2 | Symptom driven investigation performed in this hospital | Angiography performed for continuing symptoms.
 |  | 3 | Protocol driven investigation performed at another hospital | Angiography indicated on the basis of risk factors. The hospital may be within or outside your own Trust.
 |  | 4 | Symptom driven investigation performed at another hospital | Angiography indicated for continuing symptoms. The hospital may be within or outside your own Trust.
 |  | 5 | Planned after discharge | Only use this option when firm arrangements are in place before discharge.
 |  | 6 | Not applicable | For use when there is advanced malignancy, dementia, progressive neurological disease or other conditions having an immediate impact on prognosis. Includes other clinical reasons identified by the clinician.
 |  | 7 | Patient refused
 |  | 8 | Not performed
 |  | 9 | Unknown
4.14 | Coronary intervention |  |  | Coronary intervention during this episode performed either in your hospital or by referral to another hospital. Do not use for primary PCI or rescue which are covered by 3.39 and 3.40. | Code n1 | N
 |  | 1 | Percutaneous coronary intervention
 |  | 2 | CABG
 |  | 4 | PCI planned after discharge
 |  | 5 | CABG planned after discharge
 |  | 6 | Not applicable | For use when there is advanced malignancy, dementia, progressive neurological disease or other conditions having an immediate impact on prognosis. Includes other clinical reasons identified by the clinician.
 |  | 7 | Patient refused
 |  | 8 | Not performed or arranged
 |  | 9 | Unknown
4.15 | Date/time of referral for investigation/intervention |  |  | The date and time when a referral for angiography and possible intervention was made, either locally or to another centre. | DateTime | N
4.16 | Discharge destination |  |  |  | Code n1 | N
 |  | 1 | Home
 |  | 2 | Other hospital
 |  | 3 | Convalescence
 |  | 4 | Death
 |  | 8 | Other specialty in same hospital | Where a patient is transferred to another specialty for a specific reason, such as rehabilitation following a CVA, or nephrologists for dialysis.  It does NOT include a transfer from cardiologists to general physicians to continue care of the original event before discharge.
 |  | 9 | Unknown
4.17 | Daycase transfer date |  |  | The date on which transfer took place for daycase investigation and/or interventional treatment. Arranged daycase transfers are not discharged from hospital. If a patient is discharged (to another hospital) leave this field blank, and use fields 4.01 and 4.16. This allows recording of interval between referral and procedure. Dates for 4.18 and 4.19 will be the same date where PCI follows angiography at the same procedure, but it is likely that for some time angiography in a DGH to be followed by intervention elsewhere. This option will be covered by either 4.17, in the case of a day case transfer or by 4.01 & 4.16 for a patient discharged. | Date | N
4.18 | Angio date/time |  |  | Date and time of angiogram either in admitting hospital or in a second hospital, whether or not an intervention is performed. | Date/Time | N
4.19 | Local intervention date |  |  | Where this takes place in your hospital during the present admission. Use where first intervention or surgery is performed on site. | Date | N
4.20 | Interventional centre code |  |  | Code for interventional centre. | Code a3 | N
4.21 | Referring hospital code |  |  | Code of hospital from which patient was referred for any investigation or intervention. (See field 1.01 for valid codes). | Code a3
4.23 | Followed up by |  |  | Follow up refers to a formal outpatient arrangement. | Code n1 | N
 |  | 1 | Cardiologist | Includes cardiology team.
 |  | 2 | Non cardiologist
 |  | 3 | No follow up | Where no arrangement for hospital follow up is made by the discharging hospital. Do not use when patient transferred elsewhere.
 |  | 4 | Not applicable | eg patient transferred to another hospital or death in hospital.
 |  | 9 | Unknown | Unknown may be used when patient is referred to another hospital.
4.24 | Reinfarction |  |  | An event occurring during this admission. Ischaemic pain or other symptoms consistent with acute cardiac ischaemia (eg sweating, nausea, hypotension) persisting until relieved by [NAME] or nitrates, accompanied by new cardiographic changes (new ST elevation or depression or T wave changes in the territory of the initial event) These features must be accompanied by new elevation of CK or other acute marker of cardiac necrosis to more than the upper limit of normal or an increase to a value >= 50% greater than the last recorded value. | Code n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
4.26 | Date of return to referring hospital |  |  | For use when a patient is admitted to a DGH, transferred to an interventional centre and returns to the DGH. | Date | N
4.27 | Discharged on a thienopyridine inhibitor |  |  | eg Clopidogrel, Prasugrel | Code n1
 |  | 0 | No
 |  | 1 | Yes
 |  | 2 | Contraindicated
 |  | 3 | Patient declined treatment
 |  | 4 | Not applicable | For patients who die or are transferred to another hospital.
 |  | 8 | Not indicated
 |  | 9 | Unknown
4.28 | Discharged on an aldosterone antagonist |  |  | Includes Eplerenone and Spironolactone. | Code n1
 |  | 0 | No
 |  | 1 | Yes
 |  | 2 | Contraindicated
 |  | 3 | Patient declined treatment
 |  | 4 | Not applicable | For patients who die or are transferred to another hospital.
 |  | 8 | Not indicated
 |  | 9 | Unknown
4.29 | What procedure was performed at the interventional hospital? |  |  | For use by non-interventional hospitals when patients return after an intervention. This field is not to be used for nSTEMI records as it refers to primary reperfusion. | n1
 |  | 0 | No angio or primary reperfusion treatment performed
 |  | 1 | Angiogram only
 |  | 2 | Primary angioplasty
 |  | 3 | Rescue angioplasty
 |  | 4 | CABG
 |  | 5 | Thrombolytic treatment
 |  | 9 | Unknown
4.3 | Delay to performance of angiogram |  |  | This field serves to determine reasons behind delays in patients being referred for or having an angiogram following an admission with nSTEMI. The NICE guideline suggest a maximum acceptable delay to angiogram mximum of 96 hours from admission. | n1 | N
 |  | 0 |  | Angiogram performed within 96 hours from arrival at the first hospital
 |  | 1 | Delay due to comorbid clinical condition/ competing clinical issue | For example an infection, barrier nursing, active bleeding.
 |  | 2 | Capacity issues | Might include delayed transfer to the interventional hospital
 |  | 3 | Patient preference
 |  | 8 | Other
 |  | 9 | Unknown
4.31 | Discharged on Ticagrelor |  |  |  | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 2 | Contraindicated
 |  | 3 | Patient declined treatment
 |  | 4 | Not applicable | For patients who die or are transferred to another hospital
 |  | 8 | Not indicated
 |  | 9 | 9. Unknown
4.32 | High risk nSTEMI |  |  | Patients clinically suspected as having a non-ST elevation acute coronary syndrome (NSTEACS) with on-going or recurrent chest pain/discomfort believed to be of cardiac origin, together with at least one of the following: Persistent ECG changes of ST depression >1mm, or transient ST elevation; Pathological T wave inversion in V1-V4 suggesting an ‘LAD syndrome’; Dynamic T wave inversion >2mm in two or more contiguous leads; Haemodynamic (e.g.: hypotension, pulmonary oedema or heart failure) or electrical instability (sustained ventricular arrhythmias – VT/VF) which are thought to be due to cardiac ischaemia; Troponin positive/negative by whatever criteria and measurement system is used locally. NB: The above should not override ‘clinical judgement’. Any NSTEACS patient thought by the admitting hospital staff to be high risk or who potentially may benefit from early angiography/PCI should be discussed with the local cardiologists and, where appropriate, with the regional cardiac centre.  A formal risk scoring assessment (e.g.: GRACE score) should still be undertaken as part of the assessment on all patients admitted with UA/NSTEMI, in line with NICE guidance. | n1 | N
 |  | 0 | No
 |  | 1 | Yes
 |  | 9 | Unknown
5.1 | Smoking cessation advice given |  |  | As documented in case record. NICE MI secondary prevention audit criteria. | n1
 |  | 0 | No
 |  | 1 | Yes
 |  | 2 | Planned in rehab
 |  | 3 | Not  applicable
 |  | 9 | Unknown
5.2 | Dietary advice given during this admission |  |  | As documented in case record. NICE MI secondary prevention audit criteria. | n1
 |  | 0 | No
 |  | 1 | Yes
 |  | 3 | Planned in rehab
 |  | 4 | Not applicable
 |  | 9 | Unknown