This guidance updates and replaces NICE advice ESNM27

Rivaroxaban (also known as Xarelto) with aspirin alone, or with aspirin plus clopidogrel, is recommended. It is a possible treatment for adults who have had a certain type of heart problem (acute coronary syndrome with raised cardiac biomarkers). The aim is to prevent further problems, such as heart attack or stroke, caused by blood clots.

What does this mean for me?

If you have had an acute coronary syndrome with raised cardiac biomarkers, and your doctor thinks that rivaroxaban is the right treatment, you should be able to have the treatment on the NHS.

Your doctor should discuss with you the benefits and risks of taking rivaroxaban before starting or continuing treatment. No later than 12 months after starting treatment, your doctor should reassess your condition and make a decision on whether to continue treatment.

Rivaroxaban should be available on the NHS within 3 months of the guidance being issued.

Your responsibility

The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do 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.

Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so 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.

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.

  • National Institute for Health and Care Excellence (NICE)