|2004/2005/2007 Recommendation||2009 PCI Focused Update Recommendations||Comments|
|1. Patients with definite or likely UA/NSTEMI selected for an invasive approach should receive dual-antiplatelet therapy (158,159). (Level of Evidence: A) Aspirin should be initiated on presentation (158,159). (Level of Evidence: A) Clopidogrel (before or at the time of PCI) (158,159) (Level of Evidence: A) or prasugrel (at the time of PCI) (27) (Level of Evidence: B) is recommended as a second antiplatelet agent.||New recommendation|
|1. It is reasonable for initially stabilized high-riskpatients with UA/NSTEMI⁎(GRACE [Global Registry of Acute Coronary Events] risk score greater than 140) to undergo an early invasive strategy within 12 to 24 hours of admission. For patients not at high risk, an early invasive approach is also reasonable (22,23). (Level of Evidence: B)||New recommendation|
↵⁎ Immediate catheterization/angiography is recommended for unstable patients.