Stable Angina: Quality Standard

Overview

This specialist Guidelines summary of the quality standard for stable angina covers diagnosis, medical management, and revascularisation and re-evaluation of refractory symptoms in adults aged 18 and over. It describes high-quality care in priority areas for improvement.

This summary is for use by cardiology teams. For information on rationales and quality measures, refer to the original quality standard (QS21) from NICE.

List of Quality Statements

Quality Statement 1: Diagnostic Investigation

• People with features of typical or atypical angina are offered 64-slice (or above) computed tomography (CT) coronary angiography
  • Healthcare professionals offer 64-slice (or above) CT coronary angiography to people with features of typical or atypical angina.

Quality Statement 2: First-line Treatment

• People with stable angina are offered a short-acting nitrate and either a beta-blocker or calcium-channel blocker as first-line treatment
  • Healthcare professionals offer people with stable angina a short-acting nitrate and either a beta-blocker or a calcium-channel blocker as first-line treatment.

Quality Statement 3: Medical Treatment Before Revascularisation

• People with stable angina are prescribed a short-acting nitrate and 1 or 2 anti-anginal drugs as necessary, before revascularisation is considered
  • Healthcare professionals prescribe a short-acting nitrate and 1 or 2 anti-anginal drugs as necessary before revascularisation is considered in people with stable angina.

Quality Statement 4: Multidisciplinary Team

• People with stable angina who have had coronary angiography have their treatment options discussed by a multidisciplinary team if there is left main stem disease, anatomically complex three-vessel disease, or doubt about the best method of revascularisation
  • Healthcare professionals ensure people with stable angina who have had coronary angiography have their treatment options discussed by a multidisciplinary team if there is left main stem disease, anatomically complex three-vessel disease, or doubt about the best method of revascularisation.

Quality Statement 5: Symptoms Not Responding to Treatment

• People with stable angina whose symptoms have not responded to treatment are offered a re-evaluation of their diagnosis and treatment
  • Healthcare professionals offer re-evaluation of diagnosis and treatment to people with stable angina whose symptoms have not responded to treatment.