The Living Guidelines: UA/NSTEMI Recommendations for Early Risk Stratification Suggest Revisions to the CLASS IIb Guidelines

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Class IIb Guidelines

 * 1) For patients who present within 6 hours of the onset of symptoms consistent with ACS, assessment of an early marker of cardiac injury (e.g., cardiac myoglobin) in conjunction with a late marker (e.g., troponin) may be considered. (Level of Evidence: B)
 * 2) For patients who present within 6 hour of symptoms suggestive of ACS, a 2 hour delta CK-MB mass in conjunction with 2 hour delta troponin may be considered. (Level of Evidence: B)
 * 3) For patients who present within 6 hours of symptoms suggestive of ACS, myoglobin in conjunction with CK-MB mass or troponin when measured at baseline and 90 min may be considered. (Level of Evidence: B)
 * 4) Measurement of B type natriuretic peptide (BNP) or NT-pro-BNP may be considered to supplement assessment of global risk in patients with suspected ACS. (Level of Evidence: B)