This month, the National Institute for Health and Care Excellence (NICE) has published draft guidance recommending that ticagrelor, an anti-clotting drug, is prescribed to people who have had a heart attack, to prevent further heart attacks and strokes.
Currently, a higher dose of the drug (90mg) is already prescribed to heart attack patients for 12 months. However, the draft guidance recommends that a lower dose (60mg) should be taken with aspirin for a further three years to reduce the risk of any further cardiovascular events.
Coronary heart disease is the leading cause of heart attacks. It is a condition in which the coronary arteries get clogged up with deposits called plaques. Heart attacks and strokes are caused when one of the plaques ruptures, causing a clot, which can block the blood supply to the heart. If the clot dislodges, it can travel to the brain via the blood stream and cause a stroke.
In the UK, coronary heart disease is the UK’s single biggest killer, responsible for 70,000 deaths a year. There were around 140,000 hospital admissions for heart attacks in 2012/2013 and every day 515 people in the UK will attend hospital with a heart attack. Figures from The British Heart Foundation reveal that 25% of all people who have had a heart attack will have a further heart attack.
Current treatment for heart attack patients include lifestyle changes - such as exercise and healthy eating and stopping smoking - and also the use of general anti-clotting drugs to prevent clots from forming. However, NICE hopes that thousands could benefit from continuing to take a lower dose of ticagrelor.
The draft guidance recommends that ticagrelor 60mg, at a cost of approximately £1 a tablet, is taken twice a day with aspirin for up to three years for patients who have had a heart attack in the last 12 months. The guidance advises that there should be no interruption between the change in doses.
Professor Carole Longson MBE, NICE health technology evaluation centre director, stated: “Despite the availability of effective secondary prevention treatments, as many as a quarter of people who have had a heart attack go on to have another heart attack or stroke – often with devastating consequences. In provisionally recommending ticagrelor we are pleased to be able to increase the treatment options available to the many thousands of people who stand to benefit from it.”
The British Heart Foundation figures show that an estimated 915,000 people in the UK are alive today, having survived a heart attack.