NICE issues new draft guidelines on heart attack treatment

The National Institute for Health and Care Excellence (NICE) is updating its guidance on the care of people who have survived heart attacks, including new advice on the secondary prevention of myocardial infarctions.

The draft guideline, which was published on June 13 for public consultation, contains a number of important new recommendations aimed at improving the care given to hundreds of thousands of people in England and Wales who have survived heart attacks.

The guidelines were first issued in 2007 and recommended that patients took part in cardiac rehabilitation programmes to increase the chances of a healthy recovery, but because the uptake of these courses was low, the new guidelines call for interventions to ensure more patients benefit from the programmes.

Among the new recommendations issued by the organisation include a focus on the use of interventional procedures such as using stents rather than drugs as a means of widening blocked or narrowed coronary arteries.

Another notable revision to the guidelines is its removal of the advice that patients eat oily fish, or take omega-3 fatty acid capsules or omega-3 fatty acid supplemented foods in the hope of preventing further heart attacks.

It is felt that the impact these foods would have had on preventing heart attacks would be minimal when compared to new treatments that are now available.

Instead, the guidelines call for a more Mediterranean style diet. Some of the products this would encompass, include more bread, fruit, vegetables and fish, and less meat, while replacing butter and cheese with products based on plant oils.

The draft guidelines also includes recommendations on the use of drugs following a heart attack that reflect new findings on treatments to prevent blood clots (antithrombotic therapy) and on the use of drugs to reduce blood pressure and control heart rhythm and rate such as angiotensin-converting enzyme (ACE) inhibitors and beta-blockers.

Professor Mark Baker, director of the centre for clinical practice at NICE, said: ‘Healthcare professionals should ensure that a programmed of education and activity to help people recover from a heart attack and lead their lives as normally as possible, is designed to motivate people to attend and complete it.’

Taken from Journal of Paramedic Practice, published 25 June 2013.