The Living Guidelines: UA/NSTEMI Recomendations for PCI Polling Results for CLASS III Guidelines


 * Class III

1. Percutaneous coronary intervention (or CABG) is not recommended for patients with 1 or 2 vessel CAD without significant proximal left anterior descending CAD with no current symptoms or symptoms that are unlikely to be due to myocardial ischemia and who have no ischemia on noninvasive testing. (Level of Evidence: C)

 CLASS III, Recommendation 1 for PCI in UA/NSTEMI should be: CLASS I CLASS IIa CLASS IIb CLASS III

2. In the absence of high-risk features associated with UA/NSTEMI, PCI is not recommended for patients with UA/NSTEMI who have single vessel or multi vessel CAD and no trial of medical therapy, or who have 1 or more of the following:

a. Only a small area of myocardium at risk. (Level of Evidence: C)

 CLASS III, Recommendation 2a for PCI in UA/NSTEMI should be: CLASS I CLASS IIa CLASS IIb CLASS III

b. All lesions or the culprit lesion to be dilated with morphology that conveys a low likelihood of success. (Level of Evidence: C)

 CLASS III, Recommendation 2b for PCI in UA/NSTEMI should be: CLASS I CLASS IIa CLASS IIb CLASS III

c. A high risk of procedure-related morbidity or mortality. (Level of Evidence: C)

 CLASS III, Recommendation 2c for PCI in UA/NSTEMI should be: CLASS I CLASS IIa CLASS IIb CLASS III

d. Insignificant disease (less than 50% coronary stenosis). (Level of Evidence: C)

 CLASS III, Recommendation 2d for PCI in UA/NSTEMI should be: CLASS I CLASS IIa CLASS IIb CLASS III

e. Significant left main CAD and candidacy for CABG. (Level of Evidence: B)

 CLASS III, Recommendation 2e for PCI in UA/NSTEMI should be: CLASS I CLASS IIa CLASS IIb CLASS III

3. A PCI strategy in stable patients with persistently occluded infarct related coronary arteries after NSTEMI is not indicated. (Level of Evidence: B)

 CLASS III, Recommendation 3 for PCI in UA/NSTEMI should be: CLASS I CLASS IIa CLASS IIb CLASS III