This study is aiming to i)measure longterm health related quality of life (HRQL) outcomes of the EMMACE3 patients hospitalised with acute coronary syndromes (ACS) and evaluate possible associations with their cardiovascular profile and to ii) Linkage these data to multiple electronic healthcare records

Over the last few years the chance of dying from a heart attack in England and Wales has reduced dramatically. Even so, there remain huge differences in mortality between hospitals. For example, up to a third of patients with a heart attack who attend hospitals in England are more likely to die than would be expected. That is, the type of treatment and the risk of death depend upon where a patient lives and which hospital they attend. In part, the variation in death may be due to the services available at the hospital or to factors such as socioeconomic deprivation. It may also relate to other factors such as depression, cardiac rehabilitation, patient experience of hospital care and health quality of life.

Using statistical approaches that include measures of quality of life, we propose to examine data about heart attacks in England and investigate the 'postcode lottery of care'. This research is a long term followup that promote improved patient care. In doing so, different factors affecting cardiac rehabilitation will be highlighted and healthcare policy changed so that all patients will have an equal chance of surviving a heart attack.

Inclusion Criteria:

• Age>=18 years, both sexes, acute admission to hospital in England with an ACS, consented to participate in EMMACE3 study

Exclusion Criteria:

• Those in whom follow up would be inappropriate or impractical (for example patients in the terminal stages of an illness or requiring emergency treatment such that the gathering research data is not possible or appropriate.

Patients who have been hospitalised with an ACS during the period of 2011 to 2013 and took part in EMMACE3 study(REC number 10/H1313/74)