• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information

Review Protocol – BB vs CCB

ComponentDescription
Review questionWhat is the comparative clinical /cost effectiveness of standard antianginal drugs (beta blockers, calcium channel blockers,) for the management of angina?
Population
InterventionBeta blockers
atenolol, propranolol, bisoprolol, metoprolol, nadolol,

Calcium channel blockers
amlodipine, diltiazem, felodipine, nifedipine, verapamil)
ComparisonBB vs CCBs
OutcomesMortality @ longest available evaluation time point (preferred 5yr, 10 yr)
Preferred outcomes:
All cause mortality Other outcomes:
  • Cardiovascular mortality
Angina frequency/severity
Preferred outcomes:
  • Angina incidence reported in diaries
  • GTN usage
  • CCS score
Exercise tolerance (based on repeat of baseline ETT at a min of 3months follow up)
Preferred outcomes:
  • Total exercise time
Major cardiac events @ longest available evaluation time point (preferred 1yr, 5yr, 10yr)

Preferred outcome:
  • Nonfatal MI
Hospitalisation @ 6m –1yr

Revascularisation @ 1yr, 5yr, 10yr if available

Quality of Life eg EQ-5D, SF-36, HAD, etc @ longest available evaluation time point (preferred 1y, 5y, 10y)
Search strategyThe databases to be searched are Medline, Embase, The Cochrane Library, CINAHL and AMED.

Randomised controlled trials (RCTs) will be considered. If no RCTs are found for certain outcomes such as adverse events, well conducted cohort studies and observational studies may also be considered.

Studies will be restricted to English language only

No date restriction will be applied. Databases will be searched from their date of origin
The review strategyPreferred:
  • Double blind RCTs
  • Minimum n=50 or N=25 if cross over trial
  • Minimum Follow Up = 3m
  • Adverse event data to be sourced from RCTs only
For longer term outcomes (> 1 year)
  • Double blind RCTs
  • Minimum N=200 (consider studies with smaller sample size if large numbers are not available)
  • Adverse event data to be sourced from RCTs only

From: Appendix C, Review Protocols

Cover of Stable Angina
Stable Angina: Methods, Evidence & Guidance [Internet].
NICE Clinical Guidelines, No. 126.
National Clinical Guidelines Centre (UK).
Copyright © 2011, National Clinical Guidelines Centre.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

The rights of the National Clinical Guidelines Centre to be identified as Author of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.