indian man dating in 2016 - Updating an institutional chest pain algorithm


NICE recommends coronary artery bypass graft surgery to improve prognosis for patients with left main stem and/or proximal 3-vessel disease, whereas the ESC also includes proximal left anterior descending artery disease among its indications for revascularisation to improve prognosis, particularly if there is evidence of myocardial ischaemia.

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The ESC includes recommendations regarding influenza vaccination, hormone replacement therapy, and a target for Hb AIc in people with diabetes, areas which are not covered by NICE, and it makes more specific recommendations than NICE about body mass index, diet and exercise.

NICE recommends a target blood pressure of Both NICE and the ESC recommend β-blockers and/or calcium channel blockers as first-line antianginal therapy, with long-acting nitrates, ivabradine, nicorandil or ranolazine reserved for patients who have contraindications to these agents or who fail to tolerate them (table 4).

See: clinical practice guidelines most relevant to cardiologists in the UK are those produced by the National Institute for Health and Care Excellence (NICE) and the European Society of Cardiology (ESC).

Contemporary guidance is based on the same (or a very similar) evidence base, yet recommendations from the two bodies may differ.

The aim of this review was to compare the main recommendations from NICE and the ESC regarding the management of stable angina.2 Its recommendations regarding lipid modification and hypertension are specified in its own (separate) guidelines in these areas, both of which have been updated since the publication of the NICE guidance on stable angina.3 4 The ESC guidance incorporates diagnosis and management into a single document, which was published in 2013.5 It refers to its own guidelines on myocardial revascularisation, which were updated in 2014.6NICE includes in its diagnostic guideline adults with or without a prior diagnosis of cardiovascular disease who have recent onset chest pain suspected to be stable angina.