The use of glycoprotein IIb/IIIa antagonists in acute coronary syndromes: are we following the NICE guidelines?

September 2003    Volume 10, Issue 3   Br J Cardiol (Acute Interv Cardiol) 2003;10:AIC 75–AIC 77

Authors:
Julia Baron, Alice V Joy, Sarah Armstrong, Michael Millar-Craig

Recent developments in the management of non-ST elevation acute coronary syndromes (ACS) have included the introduction of glycoprotein (GP) IIb/IIIa inhibitors. The National Institute for Clinical Excellence (NICE) has published guidelines on their use, which state that these agents should be given to all high-risk patients.
Here, we present the results of a national survey of 1,000 consultant cardiologists and general physicians. A total of 361 replies were analysed: 98% of respondents treated patients with ACS and 92% of respondents had access to troponin assays. Overall, 241 (67%) of respondents prescribed GP IIb/IIIa inhibitors for ACS. There was a significant difference between cardiologists and generalists, with 194 (77%) cardiologists and 46 (42%) general physicians prescribing GP IIb/IIIa inhibitors in ACS (p=0.0013).
Despite the presence of government guidelines regarding the administration of GP IIb/IIIa antagonists in ACS, we calculate that only 32% of respondents are prescribing IIb/IIIa inhibitors as recommended by NICE

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