AIMS OF MINAP: To audit the quality of care of patients with acute coronary syndrome and provide a resource for academic research. QUALITY OF CARE INTERVENTIONS: Feedback to hospitals, ambulance services and cardiac networks regarding benchmarking of performance against national standards and targets. SETTING: All 230 acute hospitals in England and Wales. Years: 2000-present. POPULATION: Consecutive patients, unconsented. Current number of records: 735 000. STARTPOINTS: Any acute coronary syndrome, including non-ST-elevation myocardial infarction, ST-elevation myocardial infarction and unstable angina. BASELINE DATA: 123 fields covering demographic factors, co-morbid conditions and treatment in hospital. No blood resource. DATA CAPTURE: Manual entry by clerks, nurses or doctors onto Lotus Notes; non-financial incentives at hospital level. DATA QUALITY: Hospitals perform an annual data validation study, where data are re-entered from the case notes in 20 randomly selected records that are held on the server. In 2008 data were >90% complete for 20 key fields, with >80% completeness for all but four of the remaining fields. ENDPOINTS AND LINKAGES TO OTHER DATA: All-cause mortality is obtained through linkage with Office for National Statistics. No other linkages exist at present. ACCESS TO DATA: Available for research and audit by application to the MINAP Academic Group. http://www.rcplondon.ac.uk/CLINICAL-STANDARDS/ORGANISATION/PARTNERSHIP/Pages/MINAP-.aspx.