Myocardial infarction: medication for MI in preceding 12 months

  • NICE indicator
  • IND125
  • Published:
  • Last updated:
Download indicator (PDF)

Indicator

The percentage of patients who had a myocardial infarction in the preceding 1 April to 31 March and who are currently being treated with an ACE-I (or ARB if ACE-I intolerant), dual antiplatelet therapy, a statin and a beta blocker for those patients with left ventricular systolic dysfunction.

Indicator type

General practice indicator suitable for use outside the Quality and Outcomes Framework. Assessment of available data indicates an average practice population of less than 20 patients.

This document does not represent formal NICE guidance. For a full list of NICE indicators, see our menu of indicators.

To find out how to use indicators and how we develop them, see our NICE indicator process guide.

Rationale

This indicator aims to reduce associated morbidity and mortality in people who have had a myocardial infarction (MI). The NICE guideline on acute coronary syndromes recommends that all people who have had an acute MI should be offered the following drug therapy for secondary prevention of cardiovascular disease:

  • Angiotensin-converting enzyme inhibitor (ACE-I)

  • Dual antiplatelet therapy

  • Beta-blocker (if there is a record of reduced ejection fraction)

  • Statin

The indicator refers to left ventricular systolic dysfunction (LVSD) rather than reduced ejection fraction because it is the term historically used in GP practice. However, it is recommended for the ejection fraction to be recorded and for the beta blocker to be prescribed to patients with reduced ejection fraction below 40% in line with the guideline.

Source guidance

Acute coronary syndromes (2020) NICE guideline NG185, recommendations 1.4.1, 1.4.4, 1.4.7, 1.4.13, 1.4.24, 1.4.28, and 1.4.39.

Specification

Numerator: The number of patients in the denominator who are currently being treated with the following:

  • ACE-I (or ARB if there is a record of ACE-I intolerance)

  • Dual antiplatelet therapy

  • Beta-blocker (if there is a record of left ventricular systolic dysfunction)

  • Statin

Denominator: The number of patients with a record of a myocardial infarction in the preceding 1 April to 31 March.

Calculation: Numerator divided by the denominator, multiplied by 100.

Exclusions: None.

Minimum population: The indicator would be appropriate to assess performance of collaborations or networks of GP practices serving populations of around 30,000 to 50,000.

ISBN: 978-1-4731-6074-3