The Living Guidelines: UA/NSTEMI Recommendations for Initial Conservative vs Initial Invasive Strategies Suggest Revisions to the CLASS III Guidelines

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Class III Guidelines

 * 1) An early invasive strategy (i.e., diagnostic angiography with intent to perform coronary artery revascularization) is not recommended in patients with extensive comorbidities (e.g., liver failure or pulmonary failure, cancer), in whom the risks of revascularization and comorbid conditions are likely to outweigh the benefits of revascularization. (Class III Level of Evidence: C)
 * 2) An early invasive strategy (i.e., diagnostic angiography with intent to perform coronary artery revascularization) is not recommended in patients with acute chest pain and a low likelihood of Acute coronary syndromes. (Class III Level of Evidence: C)
 * 3) An early invasive strategy (i.e., diagnostic angiography with intent to perform coronary artery revascularization) should not be performed in patients who will not consent to revascularization regardless of the findings. (Class III Level of Evidence: C)