Guidance on the use of glycoprotein IIb/IIIa inhibitors in the treatment of acute coronary syndromes

Replacement of the September 2000 guidance with this revised guidance is not anticipated to increase costs to the NHS. Fewer patients undergoing elective percutaneous coronary intervention (PCI) will receive glycoprotein (GP) IIb/IIIa inhibitors, which may result in some cost savings. Under the previous guidance it was assumed that a positive troponin test would be used to identify high risk and that therefore approximately one-third of people admitted with acute coronary syndrome (ACS) would receive a GP IIb/IIIa inhibitor. The prevalence of the risk factors described in 1.4 among people admitted with ACS is unknown, but assuming a similar proportion will be identified as being at high risk as would have been identified using the troponin result, the impact of this section of the guidance remains unchanged.

The British Cardiovascular Intervention Society audit recorded 30,916 PCIs in NHS centres during 2000. However, since there are only limited data as to the case-mix of patients undergoing these procedures estimation of budget impact cannot be made.