Monday, 19 September 2011

NICE, ANGINA, SURGERY & TAGGART

The UK's NICE (National Institute for Health and Clinical Excellence) recently published guidelines for the management of stable angina. As the primary guideline setting body in the UK, what they advise is a big deal. Public health commissioning bodies look to this organisation before they decide to invest in any treatment.

Their initial drafts did not mention the role of coronary artery bypass in the management of patient with stable angina. It took heroic repeated efforts from Prof. David Taggart (picture), current president of the Society of Cardiothoracic Surgery of GB and Ireland, before NICE agreed to include CABG in the guidelines. The motives behind this omission are not clear. There were no surgeons on the initial advisory body and one of the cardiologists involved is known for his anti- surgery stance. There might also be a wider attempt at disinvestment in CABG by the National Health Service.
Many studies now show that CABG saves lives when compared to PCI (percutaneous coronary intervention). This is the latest, presented at the annual ECS (european society of cardiology) meeting in Paris in August.