What are the indications for coronary angiography in patients with NSTE-ACS?
Coronary angiography is usually indicated in patients with NSTE-ACS who have recurrent symptoms or ischemia despite adequate medical therapy or who are at high risk as categorized by clinical findings (HF, serious ventricular arrhythmias), noninvasive test findings (significant LV dysfunction with EF <0.40, large anterior or multiple perfusion defects or wall motion abnormalities on echocardiography, high-risk Duke treadmill score 11), high-risk TIMI or GRACE scores, or markedly elevated troponin levels. Additionally, patients with NSTE-ACS who have had previous PCI or CABG should also be considered for early coronary angiography, unless prior coronary angiography data indicate that no further revascularization is feasible.