In perspective: The patient at the heart of research in acute cardiovascular care.

Patient and public involvement is a fundamental part of research design and is increasingly required by research funders and regulators. In addition to the moral and ethical arguments in its favour, it has the potential to improve the accessibility and transparency of research, and to optimise study recruitment and retention. While clinical trials in acute cardiovascular care have traditionally focussed on "hard" outcomes, such as mortality or major adverse cardiovascular events, there is increasing recognition that these fail to capture the full breadth of patient experience. Patient-centred outcomes aim to measure things of greater value to patients, using validated tools to quantify symptoms, patient self-reports, or novel outcomes such as days alive and outside hospital. This In Perspective commentary explores the rationale behind patient and public involvement, the background to and evidence supporting the use of patient-centred outcomes, and discusses potential challenges and how they can be mitigated.