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Harmonising Individual Patient Level Cardiac Registry Data Across the Asia Pacific Region—A Feasibility Study of In-Hospital Outcomes of STEMI Patients From the Asia Pacific Evaluation of Cardiovascular Therapies (ASPECT) Network - 28/02/23

Doi : 10.1016/j.hlc.2022.08.012 
Christopher M. Reid, PhD a, b, , HuiJun Chih, PhD a, Stephen J. Duffy, MBBS, PhD b, c, Angela L. Brennan, CCRN b, Andrew E. Ajani, MBBS, MD b, d, John Beltrame, MBBS, PhD e, Rosanna Tavella, PhD e, Bryan P. Yan, MBBS, MD f, Diem Dinh, PhD b, Chee Tang Chin, MBChB g, h, Loi Doan Do, MD, PhD i, Quang Ngoc Nguyen, MD, PhD i, Hoai T.T. Nguyen, MD, PhD i, Ika Prasetya Wijaya, MD, PhD j, Muhammad Yamin, MD, PhD j, Lusiani Rusdi, MD j, Idrus Alwi, MD, PhD j, Kui Hian Sim, MBBS k, l, Alan Yean Yip Fong, MBChB k, l, Wan Azman Wan Ahmad, MRCP l, m, Khung Keong Yeo, MBBS g, h
on behalf of the

ASPECT Investigators

a School of Population Health, Curtin University, Perth, WA, Australia 
b School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia 
c Department of Cardiology, Alfred Health, Melbourne, Vic, Australia 
d Department of Cardiology, The Royal Melbourne Hospital, Melbourne, Vic, Australia 
e Discipline of Medicine, The University of Adelaide, Adelaide, SA, Australia 
f Division of Cardiology, Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong and Prince of Wales Hospital, Hong Kong SAR, China 
g National Heart Centre Singapore, Singapore 
h Duke-NUS Medical School, Singapore 
i Vietnam National Heart Institute, Bach Mai Hospital, Hanoi, Vietnam 
j Cipto Mangunkusumo National General Hospital, Universitas Indonesia Medical School, Jalan Pangeran Diponegoro, Jakarta, Indonesia 
k Sarawak Heart Centre, Sarawak, Malaysia 
l National Heart Association of Malaysia, Kuala Lumpur, Malaysia 
m University of Malaya Medical Centre, Jalan Universiti, Selangor, Malaysia 

Corresponding author at: Professor Christopher Reid, Curtin University, Kent Street, Bentley, WA 6102, Australia, Curtin University, GPO Box U1987, Perth, WA 6845, AustraliaCurtin UniversityKent Street, Bentley, WA 6102, Australia, Curtin UniversityGPO Box U1987PerthWA6845Australia

Abstract

Objective

The Asia-Pacific Evaluation of Cardiovascular Therapies (ASPECT) collaboration was established to inform on percutaneous coronary intervention (PCI) in the Asia-Pacific Region. Our aims were to (i) determine the operational requirements to assemble an international individual patient dataset and validate the processes of governance, data quality and data security, and subsequently (ii) describe the characteristics and outcomes for ST-elevation myocardial infarction (STEMI) patients undergoing PCI in the ASPECT registry.

Methods

Seven (7) ASPECT members were approached to provide a harmonised anonymised dataset from their local registry. Patient characteristics were summarised and associations between the characteristics and in-hospital outcomes for STEMI patients were analysed.

Results

Six (6) participating sites (86%) provided governance approvals for the collation of individual anonymised patient data from 2015 to 2017. Five (5) sites (83%) provided >90% of agreed data elements and 68% of the collated elements had <10% missingness. From the registry (n=12,620), 84% were male. The mean age was 59.2±12.3 years. The Malaysian cohort had a high prevalence of previous myocardial infarction (34%), almost twice that of any other sites (p<0.001). Adverse in-hospital outcomes were the lowest in Hong Kong whilst in-hospital mortality varied from 2.7% in Vietnam to 7.9% in Singapore.

Conclusions

Governance approvals for the collation of individual patient anonymised data was achieved with a high level of data alignment. Secure data transfer process and repository were established. Patient characteristics and presentation varied significantly across the Asia-Pacific region with this likely to be a major predictor of variations in the clinical outcomes observed across the region.

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Keywords : Cardiovascular outcome, STEMI, Registry, Asia-Pacific


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Vol 32 - N° 2

P. 166-174 - février 2023 Retour au numéro
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