ACS Unstable Angina

We have extensive experience in joint working with U.K. medical consultants The outcomes of one a number of these joint working initiatives arguably changed the way important medical conditions are now diagnosed and managed in the U.K.

This case study reviews a project designed to determine the characteristics, outcomes, prognostic indicators and management of patients with acute coronary syndromes without ST elevation - commonly known as unstable angina.

On behalf of MSD, we partnered with the Clinical Trials Evaluation Unit to conduct a registry - the Prospective Registry in Acute Ischaemic Syndrome in the UK or “PRAIS UK”). A prospective registry was carried out with follow-up for 6 months after index hospital admission. A history of acute cardiac chest pain was required plus ECG changes consistent with myocardial ischaemia and/or prior evidence of coronary heart disease. Patients with ST elevation or those receiving thrombolytic therapy were excluded. A total of 1046 patients were enrolled from 56 U.K. hospitals.

This produced clinically important findings. The rate of death or non-fatal myocardial infarction at 6 months was 12.2% and of death, new myocardial infarction, refractory angina or re-admission for unstable angina at 6 months was 30%. In this cohort there was a one in eight chance of death or myocardial infarction, and a one in three chance of death, new myocardial infarction, refractory angina or re-admission for unstable angina, over 6 months. A review of treatment strategies of unstable angina and myocardial infarction without ST elevation was felt to be warranted in the U.K. to ensure that patients are receiving optimum treatments to reduce mortality and morbidity.

The project produced a major publication in the European Heart Journal. Numerous subsequent publications followed sub analysis of the findings. The project continues to have an important impact on improving the current management of Unstable Angina.

“First class professional with a unique ability to build relationships from which business invariably followed.”
February 24, 2009. Vincent Lawton , Managing Director, Merck Sharp and Dohme Ltd

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