title: Study to Improve Cardiovascular Outcomes in high-risk older patieNts (ICON1) with acute coronary syndrome: study design and protocol of a prospective observational study.
abstract: The ICON1 study (a study to Improve Cardiovascular Outcomes in high-risk older patieNts with acute coronary syndrome) is a prospective observational study of older patients (≥75 years old) with non-ST-elevation acute coronary syndrome managed by contemporary treatment (pharmacological and invasive). The aim of the study was to determine the predictors of poor cardiovascular outcomes in this age group and to generate a risk prediction tool.
  
  
  
  Participants are recruited from 2 tertiary hospitals in the UK. Baseline evaluation includes frailty, comorbidity, cognition and quality-of-life measures, inflammatory status assessed by a biomarker panel, including microRNAs, senescence assessed by telomere length and telomerase activity, cardiovascular status assessed by arterial stiffness, endothelial function, carotid intima media thickness and left ventricular systolic and diastolic function, and coronary plaque assessed by virtual histology intravascular ultrasound and optical coherence tomography. The patients are followed-up at 30 days and at 1 year for primary outcome measures of death, myocardial infarction, stroke, unplanned revascularisation, bleeding and rehospitalisation.
  
  
  
  The study has been approved by the regional ethics committee (REC 12/NE/016). Findings of the study will be presented in scientific sessions and will be published in peer-reviewed journals.
  
  
  
  NCT01933581: Pre-results.
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Vijay
authors.initials: V
authors.lastname: Kunadian
authors.affiliation: Department of Biochemistry, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: R Dermot G
authors.initials: RD
authors.lastname: Neely
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Sinclair
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Jonathan A
authors.initials: JA
authors.lastname: Batty
authors.affiliation: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, UK.
authors.forename: Murugapathy
authors.initials: M
authors.lastname: Veerasamy
authors.affiliation: Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Ford
authors.affiliation: Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Weiliang
authors.initials: W
authors.lastname: Qiu
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D004739:England; D000073496:Frailty / Q000175:diagnosis*; D006801:Humans; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D012107:Research Design; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D015415:Biomarkers
keywords: Study design; acute coronary syndrome; older patients