Ezetimibe (Ezetrol®), which is used to treat hypercholesterolaemia in combination with a statin, has been granted a new indication by the Medicines and Healthcare products Regulatory Agency (MHRA). The drug is now also indicated to reduce the risk of cardiovascular events in patients with coronary heart disease and a history of acute coronary syndrome when added to ongoing statin therapy or started with a statin.
Most people with coronary heart disease (CHD) can be managed with lifestyle change and optimal medical therapy, but some patients need to be referred for revascularisation procedures such as angioplasty with stenting (also called percutaneous coronary intervention; PCI). Practice nurses have an important role to play in follow-up of these patients to minimise adverse events, promote lifestyle change and ensure continuing concordance with medication.
This article considers a possible scenario in primary care in which a patient presents with chest pain. Test yourself to see what you would do. Then check this against our recommendations, reflecting on your current procedures and policies within your practice.
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In this article, we look at how a primary prevention team introduced a systematic approach to target people who had premature coronary heart disease in their family and offer them a comprehensive cardiovascular disease risk assessment.Based on the findings from the EUROACTION study, the next step was to involve their partners based on the recognition that they often share risk factors due to lifestyle.
In the UK, the last 30 years have seen a significant decline in deaths from coronary heart disease (CHD) in men, but the fall has been less significant in women. This may be because women need a different, more gender-specific approach if they are to benefit fully from recent advances in treatment.
More and more of our cardiac patients are having scans to check what is going on in their hearts. There were about 1,200 single photon emission computed tomography (SPECT) scans per million population in the UK in 2000, according to the British Nuclear Cardiology Society (BNCS) survey. The National Institute for Health and Clinical Excellence (NICE) has recommended this should increase to about 4,000 scans per million population per year, based on current revascularisation and coronary angiogram rates. This article explains what is involved in a myocardial perfusion scan (MPS), giving you the information to answer your patients' questions.
Chest pain and discomfort are common symptoms that account for 1% of visits to primary care, 5% of visits to accident and emergency departments and 25% of emergency hospital admissions. Coronary artery disease (CAD) is one of many causes of chest pain and is the commonest cause of death in the UK. However, there are treatments available that can improve symptoms and prolong life, making prompt assessment and diagnosis essential. The National Institute for Health and Clinical Excellence (NICE) has recently published a new guideline on the assessment and investigation of patients presenting with acute chest pain suggestive of acute coronary syndrome (ACS) and stable chest pain suggestive of angina. It includes recommendations that will mean some changes to the way these patients are managed in practice. This article looks at how we can put these changes into action.