Table 1

Summary of methodology used in the development of the clinical practice guidelines for the management of stable angina/stable coronary artery disease from NICE and the ESC

NICEESC
DescriptionTwo separate guidelines for diagnosis and managementSingle guideline for diagnosis and management
Publication dateMarch 2010 (diagnostic); July 2011 (management)August 2013
Literature search dateTo April 2009 (diagnostic); to 22 October 2010 (management)Not stated
InclusionsDiagnostic guidelines:

  • Adults with recent onset chest pain of suspected cardiac origin with or without a history of cardiovascular disease

Management guidelines:

  • Adults aged >18 years with stable angina due to atherosclerotic disease

  • People with anginal symptoms and normal or minimally diseased coronary arteries

Stable angina
Asymptomatic patients with known CAD
Low-risk acute coronary syndrome patients (no ongoing chest pain, negative cardiac biomarkers, and a normal ECG)
Asymptomatic patients with an abnormal test
References made to microvascular dysfunction and coronary vasospasm
ExclusionsDiagnostic guidelines:

  • Non-ischaemic chest pain

  • Management of CAD once diagnosis made

Management guidelines:

  • Recent onset chest pain

  • Acute coronary syndromes

  • Angina due to non-cardiac disease e.g. anaemia or non-coronary cause e.g. aortic stenosis, hypertrophic cardiomyopathy

Not defined
Cost effectivenessAn intervention was defined as cost effective if it was both less costly in resource use and more clinically effective compared with all relevant alternative strategies, or if it cost <£20 000 per quality-adjusted life year gained compared with the next best strategyNot assessed
GuidanceSimple statementsStatements usually associated with class of recommendation (I, IIa, IIb or III)* and level of evidence (A, B or C)†

  • *I—is recommended; IIa—should be considered; IIb—may be considered; III—is not recommended.

  • †A—multiple randomised controlled trials or meta-analyses; B—single randomised controlled trial or large non-randomised studies; C—consensus of opinion and/or small studies/retrospective studies/registries.

  • CAD, coronary artery disease; ESC, European Society of Cardiology; NICE, National Institute for Health and Care Excellence.