Early conservative or early invasive approach
The 2002 ACC/AHA guidelines update made new rec-ommendations regarding the routine use of an ‘‘early conservative’’ or ‘‘early invasive’’ approach in patients with UA/NSTEMI. Patients without contraindications are routinely recommended for coronary angiography and angiographically directed revascularization. An early invasive strategy is advised in patients without serious comorbidity who are at high risk of cardiovascular events (Table 6) (Braunwald et al., 2002b). Patients treated invasively should receive GP IIb/IIIa antagonists, although the optimaltimingisnotspecified.Patientsnotdeemedtobeat high risk can be managed using either an early conserva-tive or early invasive strategy, providing they do not have contraindications for revascularization (Braunwald et al., 2002b).