This guideline covers treatments for people aged 18 and over with unstable angina (recurring chest pain) or a type of heart attack called non-ST-segment-elevation myocardial infarction (NSTEMI). It aims to ensure that people get treatment quickly. It recommends that as soon as NSTEMI or unstable angina is diagnosed, healthcare professionals assess people for risk of more serious heart problems in the future to guide their treatment.
In November 2013, recommendation 1.3.6 was changed in line with recommendations in NICE’s guideline on myocardial infarction. Recommendation 1.5.11 was updated to take into account people with a learning disability.
This guideline includes recommendations on:
- providing information
- assessing peoples’ risk of future adverse cardiovascular events
- antiplatelet and antithrombin therapy
- management strategies
Who is it for?
- Healthcare professionals
- People with NSTEMI or unstable angina and their carers
Is this guideline up to date?
We reviewed the evidence in September 2016 and we are updating the recommendations on antiplatelet therapy and management strategies.
We also propose to combine this guideline with the clinical guidelines on myocardial infarction with ST-segment elevation: acute management (CG167) and management of hyperglycaemia in acute coronary syndromes (CG130). This is being done to ensure that recommendations on the management of acute coronary syndromes fall under 1 clinical guideline.
See the guideline in development page for progress on the update
Next review: To be scheduled
Guideline development process
This guidance updates and replaces recommendations 1.2, 1.3, 1.4 and 1.6 in NICE technology appraisal 47 (September 2002) and recommendations 1.1 and 1.2 from NICE technology appraisal 80 (July 2004).
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.