Ticagrelor NICE guidance

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

The NICE guidance regarding the utilzation of Ticagrelor is as follows:

"1.1 Ticagrelor in combination with aspirin is recommended as a treatment option in adults with acute coronary syndromes (ACS) that is, people with:

ST-segment-elevation myocardial infarction (STEMI) - defined as ST elevation or new left bundle branch block on electrocardiogram - that cardiologists intend to treat with primary percutaneous coronary intervention (PCI) or non-ST-segment-elevation myocardial infarction (NSTEMI) or unstable angina - defined as ST or T wave changes on electrocardiogram suggestive of ischaemia and one risk factor for cardiovascular disease (see section 1.2)- in hospitalised patients. After treatment is initiated it should only be continued if the diagnosis is confirmed by a cardiologist.

1.2 For the purposes of this guidance risk factors for cardiovascular disease are: age 60 years or older; previous myocardial infarction; previous coronary artery bypass grafting (CABG); coronary artery disease with stenosis of 50% or more in at least two vessels; previous ischaemic stroke; previous transient ischaemic attack; previous carotid stenosis of at least 50%; previous cerebral revascularisation; diabetes mellitus; peripheral arterial disease; or chronic renal dysfunction, defined as a creatinine clearance of less than 60 ml per minute per 1.73 m2 of body-surface area."