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New treatment for heart attacks recommended

27th July 2011

New treatment for heart attacks has been recommended by the National Institute for Health and Clinical Excellence (NICE).

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In fresh guidance the regulator has recommended bivalirudin in combination with aspirin and clopidogrel for the treatment of adults who have had an ST-segment-elevation myocardial infarction (STEMI) who are undergoing primary percutaneous coronary intervention.

STEMI is caused by narrowing and blockage of the coronary artery and each year around 180,000 people in the UK are admitted to hospital with an MI and nearly 30,000 people in England and Wales die.

Bivalirudin is a type of anticoagulant, and is given intravenously at the time of the PCI, together with aspirin and clopidogrel, to prevent blood from clotting during the procedure.

The NICE appraisal compared bivalirudin with the commonly used anticoagulant heparin, used in conjunction with glycoprotein IIb/IIIa inhibitors.

Dr Carole Longson, NICE Health Technology Evaluation Centre Director, said: “With the number of PCIs being carried out increasing each year, this guidance provides the NHS in England and Wales with another important tool to enable it to treat people who have had a heart attack more effectively.

“The independent committee that advises NICE considered that, on the basis of the available evidence, bivalirudin, in combination with clopidogrel and aspirin, is both more effective and less expensive than treatment with a glycoprotein inhibitor plus heparin. It is also associated with a lower incidence of major bleeding events compared with heparin and glycoprotein inhibitors.”

NICE concluded that treatment with bivalirudin dominated treatment with heparin plus a glycoprotein inhibitor because it is cheaper and more effective.

 

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