Table 2.1. NSTE-ACS treatment strategy according to initial risk stratification.

Invasive evaluation in NSTE-ACS
Very high risk	High risk	Intermediate risk
Hemodynamic instability or cardiogenic shock	Positive troponin	DM or kidney failure
Recurrent or persistent angina refractory to clinical treatment	Dynamic ST-T change	HF or LVEF < 40%
Malignant ventricular arrhythmia or CRA	GRACE > 140	Post-AMI angina
Mechanical complications		Previous PCI or MRS
Acute HF		GRACE 109-140 or recurrent symptoms or positive functional test
Recurrent dynamic ST/T changes
Immediate invasiveHF	Early invasive(less than 24 h)AI	Invasive(less than 72 h)AI

Source: adapted from Neumann et al.³⁵⁸

AI: aortic insufficiency; AMI: acute myocardial infarction; CRA: cardiorespiratory arrest; DM: diabetes mellitus; GRACE: Global Registry of Acute Coronary Events; HF: heart failure; LVEF: left ventricular ejection fraction; MRS: myocardial revascularization surgery; PCI: percutaneous coronary intervention