Which patients with non-ST-elevation acute coronary syndrome (unstable angina and NSTEMI) are candidates for an early invasive management strategy?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

Patients with refractory angina, clinical evidence of heart failure, or hemodynamic or electrical instability who do not have serious comorbidities or contraindications to angiography/PCI should undergo an early invasive strategy.

An immediate early invasive strategy is also recommended for patient who are stable but at a high risk for clinical events. It is reasonable to consider an early invasive strategy within 24 hours of admission in patients with intermediate/high risk. For patients who fall outside this category, a delayed invasive strategy within 25 to 72 hours of admission versus a conservative (ischemia-guided) strategy may be considered. [1]


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