The Living Guidelines: Recommendations for UA/NSTEMI in Drug and Substance Abusers Suggest Revisions to the CLASS IIa Guidelines

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Class IIa Guidelines

 * 1) Administration of NTG or oral calcium channel blockers can be beneficial for patients with normal ECGs or minimal ST segment deviation suggestive of ischemia after cocaine use. (Level of Evidence: C)
 * 2) Coronary angiography, if available, is probably recommended for patients with ischemic chest discomfort after cocaine use with ST-segment depression or isolated T wave changes not known to be previously present and who are unresponsive to NTG and calcium antagonists. (Level of Evidence: C)
 * 3) Management of UA / NSTEMI patients with methamphetamine use similar to that of patients with cocaine use is reasonable. (Level of Evidence: C)