Trial DesignThe Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER)—Evaluating the impact of myocardial infarction on patient outcomes
Section snippets
Background
A number of prospective registries in patients with MI have been conducted. Among the first major US initiatives was the National Institutes of Health–sponsored Worcester Heart Attack study, which examined the epidemiology, inpatient care, and inhospital outcomes of residents of Worcester Massachusetts from 1975 through 2001.10 This was followed by a series of 4 NRMI registries, sponsored by Genentech, beginning in 1990.11 These initiatives have included >1600 hospitals throughout the United
Overview of the PREMIER registry
The primary goal of PREMIER was to provide a rich understanding of patients' health status (their symptoms, function, and quality of life) 1 year after MI. As a prototypical example, we sought to describe the prevalence of angina in the current treatment era to understand the determinants of persistent angina and to understand the consequences of angina on patients' functioning, treatment satisfaction, return to work, and quality of life. The insights garnered from such investigations could
Results
The PREMIER registry began on January 1, 2003, and ended on June 28, 2004. The quality improvement portion of the study ended on January 1, 2004. Enrolling patients required, on average, approximately 4 hours each (∼15 minutes for screening, ∼2 hours of chart abstraction, ∼45 minutes for interviews, ∼45 minutes of data entry, and ∼15 minutes of a cardiologist's time to interpret electrocardiograms and angiograms). Two centers (Swedish Medical Center and Baptist Health) terminated the study
Discussion
The Institute of Medicine has challenged the medical profession to realize its full potential by creating an American health care system that is safe, timely, efficient, equitable, evidence-based, and patient-centered.27 Realizing this latter goal of patient-centered care requires understanding patients' perspectives of their disease, the ways in which their health status is limited by symptoms and functional limitations, and how these factors impair their quality of life. PREMIER is a unique
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This study was principally supported by CV Therapeutics, Inc, Palo Alto, CA, and R-01 HS11282-01 from the Agency for Healthcare Research and Quality, Rockville, MD. This study was also supported by a Veterans Affairs Health Services Research Advanced Research Career Development Award (ARCD-98-341-2) (Dr Rumsfeld), Washington, DC.