Knowledgebase

Genetic testing for clopidogrel response (Nice 2024)

It advises that CYP2C19 genotype testing can be carried out on certain people to see if they will respond to clopidogrel.

2023: Dapagliflozin and empagliflozin in heart failure

Nice says dapagliflozin can now be used to treat heart failure.

Cardiology

CVD risk – Nice update (May 2023)

Advice updated in December, and before that May 2023 – to a flurry of media attention.

Cardiology

Subarachnoid haemorrhage update (NICE, November 2022)

Most people with a thunderclap headache don’t have SAH, but still need investigating, Dr Hudman finds.

Icosapent ethyl and high triglyceride (TAG) levels (Nice, 2022)

This is a new guideline from Nice on using icosapent ethyl in patients with high TAG levels, published on 13 July 2022.

Cardiology

Inclisiran for lipid modification in GP (Nice, 2021)

There haven’t been any direct comparisons between inclisiran and ezetimibe, alirocumab or evolocumab yet.

Lipid modification in GP (Nice update 2021)

NICE guidance on the use of bempedoic acid in lipid modification prompted me to look back at the guidance (and a useful document), writes Dr Louise Hudman.

Cardiology

Is it worth GPs’ trying to reduce patients’ saturated fat intake?

Dr Robert Walton, a senior fellow in general practice at Cochrane UK, examines evidence from a new Cochrane Review on saturated fat.

Lipid modification – NICE update (June 2021)

Nice's new guidelines for patients with 10% or more risk over 10 years caught many GPs' attention. Dr Hudman summarises the details.

Cardiology

Updated atrial fibrillation guideline from Nice

New guidance from April 2021 updates advice from 2014.

Cardiology

Abdominal aortic aneurysm (AAA) (Nice, 2020)

NICE guidance from March 2020 advises that men over 65 should be offered routine screening for AAA.

e-learning | New treatments for hyperkalaemia

New guidelines from NICE update the guidance on prescribing sodium zirconium cyclosilicate and patiromer

e-learning | Rivaroxaban for preventing atherothrombotic events

This is a new guideline from NICE advising that rivaroxaban plus aspirin can be used in the prevention of atherothrombotic events, under certain circumstances. It was published in Oct 2019. This is quite a big change in practice.

Cardiology

e-learning | Hypertension in adults

The biggest difference is that NICE encourage us to have much more of a discussion with patients about whether to start medication and what to start. Helpfully, they have provided some patient decision aids, which are really good.

Cardiology

e-Learning | Chronic Heart Failure in adults

They have pulled several different guidelines together to make this more comprehensive. There are a few new things which I'll lay out, then I'll give a brief summary of management.

Cardiology

Evolocumab and Alirocumab for treating dyslipidaemia

Sacubitril valsartan for chronic heart failure

Routine pre-operative tests and blood pressure

Nice | Edoxaban for preventing stroke and VTE in non valvular AF

Nice | Apixaban for the treatment of DVT and PE

Nice | Rivaroxaban in Acute Coronary Syndrome (ACS)

Nice | Acute heart failure

Nice | AF and heart valve disease – self monitoring using home devices

This new guidance from NICE advises that 2 new devices have been approved for home monitoring in warfarin patients with AF or heart valve problems. They are surprisingly cost-efficient for self-monitoring (eg where the patient checks their own levels and acts on them), though not for self-testing (where they just take their levels, then phones up to see what to do with them).

Nice | MI secondary prevention

Acute Coronary Syndrome

Apixaban in Atrial Fibrillation

WatchBP Home A Device

Cardiology

Ivabradine in Heart Failure

Rivaroxaban in atrial fibrillation

Dabigatran in atrial fibrillation

Nice | Ticagrelor for the treatment of acute coronary syndrome ACS

Bye-bye to bendrofluazide

Stable angina

Read GP financial advice on setting up a self assessment tax account for sessional GP work, starting out as a GP locum, how IR35 affects your GP locum, whether to join, stay or leave the NHS Pension Scheme, and what allowable expenses GP locums should record in their annual tax return.