The National Institute of Health and Care Excellence (NICE) has now published a Final Appraisal Determination recommending a lower dose of AstraZeneca's anti-clotting treatment Brilique for longer-term use in the prevention of heart attack and stroke.

Brilique (ticagrelor) 90mg is already recommended for 12 months after a heart attack to protect patients from further episodes. In new guidelines, the Institute is now also backing use of the lower 60mg dose for three years beyond this initial treatment period to help prevent another heart attack of stroke in high risk patients.

High risk patients include those having at least one of the following risk factors: being at least 65 years old; diabetes mellitus requiring medication; a second prior MI of at least one year; evidence of multivessel coronary artery disease, or chronic non-end-stage renal dysfunction.

In the UK around 70 percent of people who have a heart attack survive the event. In the first year thereafter, around one out of five have another cardiovascular event, while of those who don't, about one out of five experiences another event in the subsequent years.

"Secondary prevention for heart attack patients is critically important for their physical and psychological wellbeing" Professor Rob Storey, Professor of Cardiology, University of Sheffield. NICE's recommendation "is an important step forward in enabling us as clinicians to continue reducing patients' risk of a further atherothrombotic event, including another heart attack or stroke, in the first few years following an initial heart attack."

"With more people than ever surviving heart attacks, it is critical to recognise the need to provide ongoing management of the underlying condition in the immediate years following an attack for the prevention of further events," said Lisa Anson, country president, AstraZeneca UK and Ireland.