Myocardial Ischaemia National Audit Project (MINAP)
The Myocardial Ischaemia National Audit Project (MINAP) is a domain within the National Cardiac Audit Programme (NCAP) that contains information about the care provided to patients who are admitted to hospital with acute coronary syndromes (heart attack).
What is a heart attack?
A heart attack is a medical emergency, and you should call 999 for an ambulance immediately. It happens when there’s a sudden loss of blood flow to a part of the heart muscle. Without enough blood and oxygen your heart can be seriously damaged.
Myocardial Ischaemia National Audit Project (MINAP)
Data is collected and analysed to illustrate the ‘patient journey’ from a call to the emergency services or their self-presentation at an Emergency Department, through diagnosis and treatment at hospital, to the prescription of preventive medications on discharge. Provision of care by staff practising in participating hospitals, and, where relevant, ambulance trusts, is expressed through clinically important quality improvement/assurance indicators. The current analysis is for heart attacks admitted to hospital between 1 April and 30 September 2025. Hospital and Ambulance Trust performance, with respect to a number of aspects of care, are presented in tabular form in our interactive report.
MINAP works closely with the British Cardiovascular Society (BCS) – the body that represents and supports those professionals who work in cardiology in the UK. BCS maintains close links with patients and carers of patients with cardiac disease, and with cardiac nurses and physiologists.
2026 Interim Summary Report Key findings:
Myocardial Ischaemia National Audit Project (MINAP): marginal improvements in treatment times for patients with ST-elevation myocardial infarction but high rates of self-presentation to hospital. There has been a marginal improvement in Call-To-Door treatment times for patients with ST-elevation myocardial infarction (STEMI) up to 30 September 2025 compared to the overall results for 2024/25. Both MINAP and National Audit of Percutaneous Coronary Interventions (NAPCI) results show slight improvement in treatment times for those patients who require an inter-hospital transfer for primary PCI. Significant improvements are needed however to ensure more patients are treated within the target times set. The trends for increasing self-presentation to hospital (as opposed to calling for an ambulance) for patients with a suspected heart attack are not reversing. This is worrying as treatment times are longer for these patients and this has an impact on outcomes.
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Heart Attack (MINAP) 2026 Interim Summary Report
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Heart Attack (MINAP) 2025 2nd Edition Reports
(interactive report)
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Heart Attack (MINAP) 2025 Reports
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STEMI & NSTEMI heart attacks
Based upon electrical heart tracings – electrocardiograms or ECGs recorded during a heart attack, patients are diagnosed as having suffered either ST-elevation myocardial infarction (STEMI) or non-ST elevation myocardial infarction (NSTEMI). The management of these two forms of heart attack are broadly similar yet include important early differences.
In the annual NCAP report, the terms ‘higher-risk’ and ‘lower-risk’ have been used to differentiate STEMI from NSTEMI. Those with ST-segment elevation are most likely to have complete or nearly complete blockage of one or more coronary arteries and require primary angioplasty. Higher-risk heart attacks in the report therefore refer to STEMI – patients who are at high risk of substantial heart muscle damage or early death. Lower-risk heart attacks in the report therefore refer NSTEMI – though, because patients with NSTEMI tend to be significantly older and have more co-morbid conditions than those with STEMI, over a one-year period the risk of death is about the same in both groups.
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Myocardial Ischaemia National Audit Project (MINAP)
Data is collected and analysed to illustrate the ‘patient journey’ from a call to the emergency services or their self-presentation at an Emergency Department, through diagnosis and treatment at hospital, to the prescription of preventive medications on discharge. Provision of care by staff practising in participating hospitals, and, where relevant, ambulance trusts, is expressed through clinically important quality improvement/assurance indicators. The current analysis is for heart attacks admitted to hospital during the 12 months between 1 April 2022 and 31 March 2023. Hospital and Ambulance Trust performance, with respect to a number of aspects of care, are presented in tabular form in our interactive report.
MINAP works closely with the British Cardiovascular Society (BCS) – the body that represents and supports those professionals who work in cardiology in the UK. BCS maintains close links with patients and carers of patients with cardiac disease, and with cardiac nurses and physiologists.
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MINAP Dataset
Previous reports for Myocardial Ischaemia National Audit Project (MINAP) are available to download via the Previous reports page.
Clinical lead: Professor Chris P Gale