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- Emergency medicine
- coronary angioplasty (PCI)
- stable angina
- NSTEMI
- coronary artery disease (CAD)
- angina treatment
- angina—unstable, acute coronary syndrome
- coronary heart disease
- interventional cardiology
- PTCA
- interventional cardiology
- ischaemic heart disease
- nuclear cardiology
- nuclear medicine
- atrial fibrillation
- pacemakers
- electrocardiography
- defibrillation
- autonomic defibrillator
The Authors' reply We thank Dr Roberts and colleagues1 for their comments regarding the National Institute for Health and Clinical Excellence (NICE) clinical guidance 94 (CG94) on unstable angina and non-ST elevation myocardial infarction, which we have summarised in an earlier issue of Heart.2
We agree that risk scores should not be used in isolation to determine patient management, and NICE stresses that their documents offer guidance and should not dictate clinical practice. One of the challenges faced by our guideline development group was to place the ‘vast bodies of evidence’, referred to by Dr Roberts, into a clinically relevant context because of the variability of design, recruited populations, reported outcomes and definitions of end points in published randomised trials. We used the hard outcome of death at 6 months from randomised trials, and registry …
Footnotes
Linked article: 300405
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed