What is the standard of care for patients who present with NSTE-ACS?
The standard of care for patients who present with NSTE-ACS, including those with recurrent symptoms, ischemic electrocardiographic changes, or positive cardiac troponins, is admission for inpatient management. Initially, stabilized patients with NSTE-ACS are admitted to an intermediate (or step-down) care unit. Patients undergo continuous electrocardiographic rhythm monitoring and observation for recurrent ischemia. Bed or chair rest is recommended for patients admitted with NSTE-ACS. Patients with NSTE-ACS should be treated with antianginal, antiplatelet, and anticoagulant therapy. Patients are managed with either an early invasive strategy or an ischemia-guided strategy. Patients with continuing angina, hemodynamic instability, uncontrolled arrhythmias, or a large MI should be admitted to a coronary care unit.