The Living Guidelines: Recommendations for UA/NSTEMI in Prinzmetal’s Angina Suggest Revisions to the CLASS I Guidelines

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Class I Guidelines

 * 1) Diagnostic investigation is indicated in patients with a clinical picture suggestive of coronary spasm, with investigation for the presence of transient myocardial ischemia and ST-segment elevation during chest pain. (Level of Evidence: A)
 * 2) Coronary angiography is recommended in patients with episodic chest pain accompanied by transient ST segment elevation. (Level of Evidence: B)
 * 3) Treatment with nitrates and calcium channel blockers is recommended in patients with variant angina whose coronary angiogram shows no or non obstructive coronary artery lesions. Risk factor modification is recommended, with patients with atherosclerotic lesions considered to be at higher risk. (Level of Evidence: B)