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Evaluation of the Methods and Management of Acute Coronary Events (EMMACE)


Cardiovascular disease is the leading cause of death in the UK and is responsible for over four million deaths per year in Europe.

The Evaluation of the Methods and Management of Acute Coronary Events (EMMACE) studies are a suite of prospective cohort studies which are designed to improve our understanding of care and outcomes patients hospitalised with acute coronary syndrome (ACS). The Chief Investigator is Chris P Gale, Professor of Cardiovascular Medicine, Honorary Consultant Cardiologist, University of Leeds. The studies have been supported by funding from the National Institute for Health Research and the British Heart Foundation.

For EMMACE-3 & -4, consented participants completed health related quality of life and medication adherence questionnaires at multiple times after their hospitalisation with ACS.  Data were collected about GP and hospital specialists’ appointments as well as information about physical activity, cardiac rehabilitation and prescribed medications. Participants have agreed to be followed up through their electronic health records for up to 20 years after their data of consent into the study.

The studies have reported variations in hospital outcomes, temporal improvements in the adherence to guideline-recommended therapies and their association with a decline in mortality rates, impact of cardiac rehabilitation on survival, impact of clinical investigations and treatments on mortality, and the relative impact of diabetes on early and late mortality by temporal changes in hospital care. The studies have also showed that although health related quality of life has improved for the majority of patients with heart attack, it is worse and more likely to decline for women, people who had experienced an NSTEMI type of heart attack and among people with long-term health conditions.

EMMACE-XL, and longer-term follow-up study will open to recruitment in 2020 and ask participants in EMMACE 3 and 4 to complete a further questionnaire regarding their quality of life, prescribed medications and lifestyle.

If you have taken part in EMMACE 3 and 4 and are thinking about participating in EMMACE XL, information regarding how we handle your data may be found here.


Professor Chris P Gale


EMMACE is a part of a number of activities by the Cardiovascular Epidemiology research group