The Living Guidelines: Initial Conservative versus Initial Invasive Strategies in patients with Unstable Angina / Non ST Elevation MI Suggest Revisions to the CLASS IIa Guidelines

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Class IIa Guidelines

 * 1) Percutaneous coronary intervention is reasonable for focal saphenous vein graft lesions or multiple stenoses in UA / NSTEMI patients who are undergoing medical therapy and who are poor candidates for re-operative surgery. (Class IIa Level of Evidence: C)
 * 2) Percutaneous coronary intervention (or CABG) is reasonable for UA / NSTEMI patients with one or  two vessel CAD with or without significant proximal left anterior descending CAD but with a moderate area of viable myocardium and ischemia on noninvasive testing. (Class IIa Level of Evidence: B)
 * 3) Percutaneous coronary intervention (or CABG) can be beneficial compared with medical therapy for UA / NSTEMI patients with 1-vessel disease with significant proximal left anterior descending CAD. (Class IIa Level of Evidence: B)
 * 4) Use of PCI is reasonable in patients with UA / NSTEMI with significant left main CAD (greater than 50% diameter stenosis) who are candidates for revascularization but are not eligible for CABG or who require emergency intervention at angiography for hemodynamic instability. (Class IIa Level of Evidence: B)