Guidance

Update information

Update information

November 2020: This guideline updates:

  • NICE guideline CG172 (published November 2013)

  • NICE guideline CG167 (published July 2013)

  • NICE technology appraisal guidance 230 (published July 2011)

  • NICE guideline CG94 (published March 2010)

  • NICE technology appraisal guidance 152 (published July 2008)

  • NICE technology appraisal guidance 71 (published October 2003).

It incorporates unchanged NICE guideline CG130 (published October 2011).

We have reviewed the evidence on dual antiplatelet therapy, early angiography for unstable angina and non‑ST‑segment elevation myocardial infarction (NSTEMI), antithrombin therapy before percutaneous coronary intervention (PCI), complete revascularisation versus culprit vessel only PCI for ST‑segment elevation myocardial infarction (STEMI), drug-eluting stents, combination antiplatelet and anticoagulant treatment for people with a separate indication for anticoagulation, and duration of beta-blocker treatment for people with reduced left ventricular ejection fraction after MI. We have made new recommendations. These recommendations are marked [2020].

We have also made some changes without an evidence review:

  • We have aligned terminology with the NICE guideline on chronic heart failure in adults.

  • We have clarified advice on drug therapy for secondary prevention to indicate that dual antiplatelet therapy may not be suitable for people with a separate indication for anticoagulation.

  • We have indicated when to offer a cardiology assessment to someone who has had a previous MI.

These recommendations are marked [2007, amended 2020].

Minor changes since publication

December 2024: We added links to relevant technology appraisal guidance in the sections on dual antiplatelet therapy, coronary angiography with follow-on PCI, drug therapy for secondary prevention and people with reduced left ventricular ejection fraction.

December 2021: Following a surveillance review we have updated recommendation 1.3.7 to say that either glycosylated haemoglobin (HbA1c) or fasting blood glucose may be used to test for diabetes. Recommendation 1.3.3 on using both tests before discharge from hospital in people with hyperglycaemia after acute coronary syndrome has not changed.

ISBN: 978-1-4731-3902-2