Coronary Artery Disease
Coronary (ischaemic) heart disease is the single biggest killer worldwide and the leading cause of premature death in UK men. Risk is largely modifiable.
- ≈ 2.3m
people in the UK live with coronary heart disease.
- 63,000
UK deaths a year from coronary heart disease.
- QRISK3 ≥ 10%
NICE threshold for offering a statin for primary prevention.
Source: NICE NG238
QRISK3 and the statin threshold
NICE NG238 recommends using the QRISK3 calculator for adults up to 84. Atorvastatin 20 mg is offered for primary prevention when 10-year CVD risk is ≥ 10%, and atorvastatin 80 mg for secondary prevention.[3]NICE NG238
Meta-analysis of statin trials by the CTT Collaboration showed each 1 mmol/L reduction in LDL cholesterol cuts major vascular events by about 22%.[5]CTT, Lancet 2010
When the artery blocks
For ST-elevation myocardial infarction (STEMI), NICE NG185 recommends primary percutaneous coronary intervention (PCI) within 120 minutes of when fibrinolysis could have been given. Door-to-balloon time is a key NHS quality indicator.[4]NICE NG185
- [1] British Heart Foundation. UK CVD Factsheet · January 2026 (2024 data)
- [2] NHS. Coronary heart disease · 2024
- [3] NICE. Cardiovascular disease: risk assessment and reduction — NG238 · 2023
- [4] NICE. Acute coronary syndromes — NG185 · 2020
- [5] Cholesterol Treatment Trialists' Collaboration, Lancet. Efficacy and safety of more intensive lowering of LDL cholesterol · 2010