The Living Guidelines: UA/NSTEMI Recommendations for Early Risk Stratification Polling Results for CLASS IIa Guidelines

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Class IIa Guidelines
1. Use of risk stratification models, such as the Thrombolysis In Myocardial Infarction (TIMI) or Global Registry of Acute Coronary Events (GRACE) risk score or the Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) risk model, can be useful to assist in decision making with regard to treatment options in patients with suspected ACS. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 1 for Early Risk Stratification should be: CLASS I CLASS IIa CLASS IIb CLASS III 2. It is reasonable to remeasure positive biomarkers at 6 to 8 hours intervals, 2 to 3 times or until levels have peaked, as an index of infarct size and dynamics of necrosis. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 2 for Early Risk Stratification should be: CLASS I CLASS IIa CLASS IIb CLASS III 3. It is reasonable to obtain supplemental ECG leads V7 through V9 in patients whose initial ECG is non diagnostic to rule out MI due to left circumflex occlusion. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 3 for Early Risk Stratification should be: CLASS I CLASS IIa CLASS IIb CLASS III 4. Continuous 12 lead ECG monitoring is a reasonable alternative to serial 12-lead recordings in patients whose initial ECG is non diagnostic. (Level of Evidence: B)

 UA/NSTEMI Guidelines Class IIa Recommendation 4 for Early Risk Stratification should be: CLASS I CLASS IIa CLASS IIb CLASS III