Transparency agenda

The information available from this webpage comes from the Myocardial Ischaemia National Audit Project (MINAP). The audit covers all hospital in England that admit acute coronary syndrome patients. The data were first published in the MINAP 2011 public report.

  • MINAP public report 2012

What information is being made available?

The following MINAP analyses are available on data.gov.uk:

  • use of reperfusion treatment by hospital, ambulance service and cardiac network
  • use of secondary prevention medication on discharge by hospital. 

These data do not contain data about individual patients nor do they contain any patient identifiable data.

Using and interpreting the data

Data from MINAP requires careful interpretation and the information should not be looked at in isolation when assessing standards of care. Where a hospital reports less than 20 cases per year, analysis may not be meaningful and the number of cases are shown but not the percentages.

Are all hospitals included?

Data are provided by all hospitals in England that admit acute coronary syndrome patients.

What period do the data cover?

These data were extracted from the MINAP database and include patients with a date of admission between 1 April 2009 and 31 March 2011.

If you require more information, please contact us by email:

minap-nicor [at] ucl.ac.uk

Primary angioplasty by hospital

Primary angioplasty within 90 mins of arrival reflects the ability of a hospital to provide treatment in a timely manner. Primary angioplasty within 150 mins of calling for help reflects hospital performance and that of the emergency services in identifying STEMI patients and taking them to the interventional centre (which may not be the closest hospital). Not all patients are taken directly to an interventional centre, especially where there is diagnostic uncertainty. This inevitably takes longer than direct transfer, but cannot be avoided in some cases.

Primary angioplasty within 90 mins of arrival at interventional centre: % of patients with an initial diagnosis of STEMI who receive primary angioplasty within 90 mins of arrival at the interventional centre.

Primary angioplasty within 150 mins of calling for help: % of patients with an initial diagnosis of STEMI who receive primary angioplasty within 150 mins of calling for professional help.

Primary angioplasty within 150 mins of calling for help for patients with direct admission to interventional centre: % of patients with an initial diagnosis of STEMI who are admitted directly to an interventional centre who receive primary angioplasty within 150 mins of calling for professional help.

Primary angioplasty within 150 mins of calling for help with for patients transferred to interventional centre: % of patients with an initial diagnosis of STEMI who are first admitted to a non interventional centre and are then transferred to an interventional centre, who receive primary angioplasty within 150 mins of calling for professional help.

% of patients with a direct admission to interventional centre: % of patients who receive primary angioplasty who are admitted directly to an interventional centre.

Thrombolytic treatment by hospital

The small numbers having thrombolytic treatment reflects the dominance of primary angioplasty as the reperfusion treatment of choice for STEMI.

Hospitals that do not provide primary angioplasty may report few, if any, cases having thrombolytic treatment as patients from their area will be admitted directly to an interventional centre. About 18% of patients make their own way to hospital without either involving the ambulance service or their GP. These patients are excluded from analysis of call to needle time and may account for small numbers in some hospitals.

Thrombolytic treatment within 30 mins of hospital arrival: % of patients with an initial diagnosis of STEMI who received thrombolytic treatment within 30 mins of hospital arrival.

Thrombolytic treatment within 60 mins of calling for help: % of patients with an initial diagnosis of STEMI who received thrombolytic treatment within 60 mins of calling for professional help.

Reperfusion treatment by ambulance

Ambulance services collaborate closely with receiving hospitals and networks to improve care. For many, the focus has shifted from provision of pre-hospital thrombolytic treatment to identifying those patients with heart attack who might benefit from primary angioplasty, and transferring them rapidly to a heart attack centre. So, for many ambulance services, the number of patients receiving pre-hospital thrombolytic treatment has declined.

Patients having thrombolytic treatment within 60 mins of calling for help: % of patients with an initial diagnosis of STEMI who received thrombolytic treatment within 60 mins of calling for professional help.

Patients having pre-hospital thrombolysis: % of patients with an initial diagnosis of STEMI who received thrombolysis administered by ambulance paramedics before arrival at hospital.

Primary angioplasty within 150 mins of calling for help for patients with direct admission to the interventional centre: % of patients with an initial diagnosis of STEMI who are admitted directly to an interventional centre who received primary angioplasty within 150 mins of calling for professional help.

Table 3: Reperfusion treatment by Ambulance service (csv)

Secondary prevention medication on discharge by hospital

These analyses are based on all patients discharged from hospital with a diagnosis of myocardial infarction (STEMI and nSTEMI). Patients are excluded if they are transferred from the admitting hospital to another hospital for further treatment. Patients are also excluded from analysis if there is a contraindication to a drug, if they refuse treatment, or have severe non cardiac co-morbidity that limits prognosis.

Aspirin: % of eligible patients who were discharged on aspirin

Beta blocker: % of eligible patients who were discharged on a beta blocker

Statins: % of eligible patients who were discharged on a statin

ACE inhibitor: % of eligible patients who were discharged on an ACE inhibitor or Angiotensin receptor blocker

Clopidogrel/thienopyridine inhibitor: % of eligible patients who were discharged on  Clopidogrel or a thienopyridine inhibitor.

Reperfusion treatment by cardiac network

Thrombolytic treatment within 60 mins of calling for help: % of patients with an initial diagnosis of STEMI who received thrombolytic treatment within 60 mins of calling for professional help.

Primary angioplasty within 150 mins of calling for help: % of patients with an initial diagnosis of STEMI who receive primary angioplasty within 150 mins of calling for professional help.

Patients having pre-hospital thrombolysis: % of patients with a discharge diagnosis of STEMI who received thrombolysis administered by ambulance paramedics before arrival at hospital.

Patients having in-hospital thrombolysis: % of patients with a discharge diagnosis of STEMI who received thrombolysis in hospital.

Patients having primary angioplasty: % of patients with a discharge diagnosis of STEMI who received primary angioplasty.

Patients having no reperfusion treatment: % of patients with a discharge diagnosis of STEMI who received no reperfusion treatment.

Care of patients with non ST elevation MI (NSTEMI) by hospital

It is recognised that not all nSTEMI patients are entered into MINAP. A number of hospitals report a lack of resources to collect data on nSTEMI, and more generally those patients not admitted to a cardiac unit are less likely to be entered. Thus the percentages reported below do not take into account every patient admitted to hospital with nSTEMI. In addition some hospitals in the London area that have no nSTEMI patients recorded are participating in a project for direct admission of these patients to a Heart Attack Centre in a manner similar to that for primary angioplasty for STEMI.

nSTEMI patients admitted to cardiac unit or ward: % of patients with a discharge diagnosis of nSTEMI who were admitted to a cardiac unit or ward.

nSTEMI patients seen by a cardiologist or member of team: % of patients with a discharge diagnosis of nSTEMI who were seen by a cardiologist or member of their team.

To help explain the terminology used NICOR have produced a MINAP specific glossary and a summary sheet.

  • MINAP glossary (doc)
  • MINAP transparency summary sheet (doc)

Page last modified on 06 feb 13 15:43