Treatment of Unstable Angina in NSTE-ACS with High-Risk Criteria: GRACE Score >140, Dynamic ECG Changes, or Transient ST Elevation
This protocol applies to patients with a working diagnosis of NSTE-ACS / unstable angina who do not meet very high-risk criteria but carry at least one high-risk finding that shapes the management strategy.
Clinical scenario
Working diagnosis of NSTE-ACS / unstable angina, without very high-risk features, with at least one of the following high-risk criteria: GRACE risk score above 140; transient ST-segment elevation on ECG; or dynamic ST-segment or T wave changes on ECG. In this population, an early invasive strategy within 24 hours should be considered.
Treatment overview (partial)
The protocol addresses a revascularization pathway applicable when specific coronary anatomy conditions are present. The complete decision criteria, sequencing, and full management steps are available in the structured protocol.
References
DOI: 10.1093/eurheartj/ehad191
An early invasive strategy within 24 h should be considered in patients with at least one of the following high-risk criteria:
Dynamic ST-segment or T wave changes
Transient ST-segment elevation
GRACE risk score >140
In patients with coronary anatomy unsuitable for PCI, emergency CABG is recommended.
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