Tag Archives: stable angina

Introduction For many years, the exercise tolerance test (ETT) has been the first-line investigation in patients presenting with stable chest pain. However, equivocal and false-positive results often lead to additional investigations. In recent years, computed tomography (CT) coronary angiography (CTCA) has been demonstrated to have excellent negative predictive value, making it a useful test to rule out obstructive coronary artery disease (CAD).1-3 In 2010, the UK National Institute for Health and Care Excellence (NICE) published clinical guideline 95: ‘Chest pain of recent onset’. This guideline advocates the use of a new risk estimatio

Introduction Stable angina is the most common manifestation of coronary heart disease. While considered relatively benign in terms of prognosis, the condition confers a higher risk of cardiovascular events than in the general population, with average annual mortality rates of 1–2%. Guidelines for the management of stable angina are relatively conservative in their approach, given their process of development. Moreover, stable angina management has not been as rigorously evaluated in large randomised trials as other coronary conditions. The role of newer treatment options in management algorithms also merits wider consideration. This expert

Future improvements Ongoing improvements were also showcased at the NHSI event. These included the reduction of strokes attributable to atrial fibrillation (AF) through use of the Guidance on Risk Assessment for Stroke Prevention in Atrial Fibrillation (GRASP-AF) risk management tool. Used by GP practices to identify patients registered for AF, it highlights patients with a CHADS2 score of 2 or more not currently receiving anticoagulant treatment. Identified patients can be reviewed for suitability for anticoagulation, to reduce overall stroke mortality. NHSI is committed to increasing GRASP-AF use from 830 to 2,000 GP practices by April 2012

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