Cardiovascular disease is the leading cause of emergency hospitalisation in Europe, a leading cause of death and disability and has major impacts on global health economies. Throughout the world, but especially in the UK, there are substantial quantities of rich longitudinal and cross-sectional cardiovascular data available to study the quality of care and outcomes. England is unique in that it is one of the only countries in the world with continuous national cardiovascular data collection.

The cardiovascular epidemiology research group, led by Professor Chris Gale, is part of the Division of Epidemiology and Biostatistics within the Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM).

Interests and activity

The group investigates outcomes of specific cardiovascular diseases including;
– acute coronary syndromes
– heart failure
– cardiac rhythm disorders
– out of hospital cardiac arrest
– percutaneous cardiovascular interventions.

Utilising descriptive and analytical epidemiological techniques to better understand and improve the quality of care for patients with cardiovascular disease.

The group uses regional and national, clinical and administrative, independent and bespoke linked cardiovascular databases, including:
– Myocardial Ischaemia National Audit Project (MINAP)
– British Cardiovascular Intervention Society (BCIS) database
– National Audit of Cardiac Rehabilitation (NACR)
Hospital Episode Statistics (HES)
Evaluation of the Methods and Management of Acute Coronary Events (EMMACE)-1, 2, 3 & 4 databases.

Using national data as a platform for registry-based randomised, controlled trials – for example, to test clinical interventions which may improve adherence to guideline-recommended therapies and reduce premature cardiovascular deaths.

The research group have a specific interest in acute coronary syndromes (heart attacks), but also investigate other cardiovascular diseases such as heart failure, percutaneous coronary interventions (angioplasty and TAVI), cardiac surgery and arrhythmias such as atrial fibrillation.

Additionally, studying healthcare performance, provider (Primary Care, hospital and healthcare professional) variations in care, quantify missed care opportunities and evaluate contemporary approaches to the management of cardiovascular disease and its outcomes.

Key collaborations

The Cardiovascular Epidemiology group have a number of successful national and international collaborations, with some examples listed below.

National Institute for Cardiovascular Outcomes Research (NICOR), University College London
NICOR uses the national cardiovascular registries to provide information to improve heart disease patients’ quality of care and outcomes. This helps the government and regulatory bodies improve quality by checking care meets good medical practice standards.

UCL Research Department of Epidemiology and Public Health, University College London
Prof Chris Gale is a collaborative partner of the CALIBER project which uses electronic health records to study the prognostically important sub-types of heart attacks (CI: Professor H Hemingway).

Out of Hospital Cardiac Arrest, Warwick University
Prof Chris Gale is a collaborative partner and Steering Committee member for the national out of hospital cardiac arrest registry studying the variation in treatment and outcomes of cardiac arrest.

National Audit of Cardiac Rehabilitation, University of York
Prof Chris Gale is a collaborative partner and Steering Committee member for the national audit of cardiac rehabilitation arrest registry studying the provision of cardiac rehabilitation services to cardiovascular patients.

Karolinska Institutet, Sweden
Prof Chris Gale is a collaborative researcher undertaking international comparative effectiveness studies of cardiovascular disease.

Aarhus University, Denmark
Prof Chris Gale is a collaborative partner undertaking international comparative analyses of the diffusion of primary PCI for acute myocardial infarction.